Abstract: Context: Benign prostatic hypertrophy (BPH) is a common condition that can result in bothersome lower urinary tract symptoms. Aims: The study aimed to determine the efficacy of tamsulosin, finasteride and combination therapy in patients with benign prostatic hyperplasia and to observe the quality of life in all the 3groups. Settings and Design: A prospective observational study was carried out in the department of surgery of a tertiary care hospital. Methods and Material: Benign prostatic hyperplasia (BPH) patients who fulfilled the inclusion and exclusion criteria were enrolled into the study and were assigned to any one of the 3 groups randomly, G1-Tamsulosin, G2-finasteride and G3-combination therapy (tamsulosin + dutasteride). Patients were monitored during the hospital stay and followed up until discharge. Severity of symptoms was observed by administering AUA symptom score questionnaire either in English or in tamil. Statistical analysis used: All statistical analysis was performed using SPSS 17.0 and graph pad prism 7.0. Unpaired student t –test was used to compare two groups and p value less than 0.05 was considered statistically significant throughout the study (95% of confidence interval). Results: A total of 120 patients, most of the age group ranging from 61-70 yrs (54.16%). There were no significant differences in baseline characteristics. There was significant differences in group wise pre and post drug therapy (p<0.0001) and the treatment efficacy was not similar between the treatment groups (P <0.05). Conclusion: Combinational therapy was observed to be more efficacious than monotherapy with either tamsulosin or finasteride therapy. Hence it is recommended that combinational therapy can be preferred over monotherapy in the management of BPH in elderly males with or without over active bladder.