Background: Benign prostatic hyperplasia (BPH) is highly prevalent in elderly men and often results in lower urinary tract symptoms (LUTS). The present study was conducted to compare the efficacy of tadalafil with tamsulosin in the treatment of lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH). Materials & Methods: 78 patients of diagnosed with LUTS secondary toBPHwere divided into 2 groups. Group I were given tadalafil 5 mg and group II tamsulosin 0.4 mg. Maximum flow rate (Qmax), Postvoid residual urine (PVR), International Prostate Symptom Score (IPSS), International Prostate Symptom Score Quality of life (IPSS QoL) and Sexual Health Inventory for Men (SHIM) scoring were compared. Results: mean prostate size in group I was 32.5 gram and in group II was 30.1 gram. Qmax was 13.6 ml/sec in group I and 12.8 ml/sec in group II. PVR was 51.4 ml in group I and 83.2 ml in group II. IPSS was 12.7 in group I and 14.9 in group II, IPSS QoL was 2.3 in group I and 3.0 in group II. The difference was significant (P< 0.05).