Objective: To study the effect of finasteride (Fin) combined with transurethral plasma electrocision of the prostate (TUPKP) in the treatment of prostatic hyperplasia (BPH). Methods: A total of 102 patients with BPH in our hospital were selected as the research subjects. The case collection period was from January 2023 to December 2024. All the included subjects were randomly divided into the simple surgery group and the surgery + medication group, with 51 cases in each group. The simple surgery group received TUPKP treatment, and the surgery + drug group was given Fin treatment on the basis of the simple surgery group. The perioperative conditions (operation duration, irrigation fluid volume, irrigation duration, hospital stay), prostate symptom score (IPSS), maximum urine flow rate (Qmax), serum epidermal growth factor (EGF), complications and Quality of life Questionnaire 36 (SF-36) score were compared between the surgery + drug group and the simple surgery group. Results: Compared with the simple surgery group, the operation + medication group had shorter operation duration, shorter irrigation duration, shorter hospital stay, and less irrigation fluid volume (P < 0.05); Three months after the operation, the IPSS scores and EGF levels in both the surgery + drug group and the simple surgery group were lower than those before the operation, and the score in the surgery + drug group was lower than that in the simple surgery group. The Qmax score was higher than that before the operation, and the score in the surgery + drug group was higher than that in the simple surgery group (P < 0.05). The incidence of complications in the surgery + medication group was 1.96% (1/51), which was lower than 15.69% (8/51) in the simple surgery group (P < 0.05); Three months after the operation, the SF-36 scores of both the operation + drug group and the simple operation group were higher than those before the operation, and the operation + drug group was higher than the simple operation group (P < 0.05).. Conclusion: Fin combined with TUPKP for BPH can optimize the perioperative situation, reduce the amount of flushing fluid, improve the inflammation and clinical symptoms in the patient"s body, increase the rate of urinary flow, reduce the occurrence of postoperative dizziness, bleeding and other complications, and the therapeutic effect is outstanding.