To review the function of prostate MRI in the diagnosis and treatment of benign prostatic hyperplasia (BPH) and related lower urinary tract symptoms (LUTS). BPH/LUTS is a frequent cause of morbidity in older men. Because of its capacity to give excellent anatomic information, mpMRI has become an increasingly preferred technique for prostate imaging. This has enabled MRI categorization of BPH as well as comprehensive assessment of response to different BPH treatment techniques such as simple prostatectomy and transurethral resection of the prostate, as well as newer treatments such as UroLift and prostatic artery embolization. 

MRI will continue to be a valuable technique in the diagnosis and management of BPH/LUTS, as well as in providing information on the efficacy of a number of current treatment approaches. Additional research is required to properly define the impact of current BPH treatments on mpMRI.