Objective: To explore the effect of ureteroscopic holmium laser combined with transurethral resection of the prostate in the treatment of benign prostatic hyperplasia with bladder stones. Methods: The clinical data of 84 patients with BPH combined with bladder stones admitted to our hospital from March 2023 to April 2024 were retrospectively collected. The patients were divided into the control group [treated with suprubic cystotomy (small incision) for stone removal combined with transurethral resection of the prostate, 44 cases] and the observation group (treated with ureteroscopic holmium laser combined with transurethral resection of the prostate, 40 cases) according to the differences in surgical methods. The clinical therapeutic effects, perioperative indicators, urodynamic indicators and the incidence of adverse reactions of the two groups were statistically compared. Result: The total effective rate of treatment in the observation group was significantly higher than that in the control group (P < 0.05). Compared with the control group, the specific intraoperative blood loss in the observation group was significantly reduced, and the specific duration of bladder irrigation and hospital stay were significantly shortened (P < 0.05). Three months after the operation, the IPSS scores and RUV of both groups were significantly lower than those before the operation, and the Qmax was significantly higher than that before the operation. Moreover, the changes in the IPSS scores, Qmax and RUV of the observation group were significantly greater than those of the control group (P < 0.05). The incidence of adverse reactions in the observation group was significantly lower than that in the control group (P < 0.05). Conclusion: Ureteroscopic holmium laser combined with transurethral resection of the prostate for the treatment of BPH complicated with bladder stones can improve the therapeutic effect, promote postoperative recovery, improve urodynamics, and enhance the safety of treatment.