The purpose of this review is to revisit the medical treatment of benign prostatic hyperplasia in the light of the most recent data concerning the association of alpha-blockers and 5alpha-reductase inhibitors. Combining these two drugs is not a new concept in treating benign prostatic hyperplasia patients. Alpha blockers are believed to improve symptoms and flow rate by inducing relaxation of the smooth muscle neck and prostate area (dynamic component), while 5alpha-reductase inhibitors are believed to improve symptoms and flow rate by shrinking the transition zone of the prostate through hormonal mechanisms (static component). The proof of this concept, however, could not be clinically demonstrated up until now. The design of previous studies investigating combination therapy with the 5alpha-reductase inhibitor finasteride has been questionable.