BACKGROUND: Benign prostatic hyperplasia (BPH) is a common male urological disease around the world. This study aimed to evaluate global, regional, and national burden of BPH from 1990 to 2021, and to forecast the incidence and prevalence of BPH to 2035. METHODS: Using the data and methods of the Global Burden of Disease 2021, we presented the incidence, prevalence, and disability-adjusted life-years (DALYs) of BPH from 1990 to 2021. The trends of burden over time were assessed using estimated annual percentage changes. We applied Bayesian age-period-cohort model to forecast the incidence and prevalence of BPH to 2035. RESULTS: In 2021, the global number of incident cases, prevalent cases, and DALYs of BPH were 137.88, 1125.02, and 22.36 per 100,000 populations, respectively. From 1990 to 2021, the age-standardized incidence rate (ASIR), age-standardized prevalence rate (ASPR), and age-standardized DALYs rate (ASDR) of BPH remained stable. The highest ASIR, ASPR, and ASDR were recorded in Eastern Europe in 2021. Nationally, China had the highest number of incident cases, prevalent cases, and DALYs of BPH. With the increase of socio-demographic index, the trends of ASIR, ASPR, and ASDR all exhibit an initial rise followed by a gradual decline. The global incidence and prevalence are expected to increase from 962.42 to 7878.68 per 100,000 populations in 2022 to 998.55 and 8620.60 per 100,000 populations in 2035, respectively. CONCLUSIONS: The persistent burden of BPH continues to pose a critical public health challenge. The escalating prevalence among middle-aged and elderly populations underscores the imperative to tackle this widespread condition.