Enlarged prostate is one of the most common urinary tract illness encountered in elderly males. Prostate volume is a well-established single most important predictor for management of patients with prostatomegaly, presenting with lower urinary tract symptoms. The aim of this study is to find a correlation between IPSS, PSA and prostate volume measured by transrectal ultrasound and its impact on patient management. A total of 120 men >40 years of age with lower urinary tract symptoms underwent transrectal ultrasound for the estimation of prostate volume after the laboratory investigation for prostate specific antigen levels in blood and response to clinical questionnaire for International Prostate Symptoms Score. The prostate ranged from 10 cc to 130 cc, mean being 37.04 cc +18.81. As per grading by IPSS, 52 patients (43.3%) had severe symptoms, followed by moderate symptoms in 44 patients (36.6%) and only 24 patients (20%) were having mild symptoms. PSA values ranged from .04 to 19.5 ng /ml. with a mean value of 4.2 + 1.89 ng / ml. Significant correlation is found between prostate volume, IPSS and PSA with moderate but statistically significant correlation between IPSS and PSA. Thus, combined parameters of prostate volume, IPSS and PSA could serve as an eminent tool for making clinical decisions and surgical management of patients with lower urinary tract symptoms due to enlarged prostate.