Cystoscopy has a limited role in the evaluation of benign prostatic hyperplasia (BPH). The examination is recommended in the evaluation of BPH patients with hematuria or a history of risk factors for urethral stricture. Available data suggest that bladder trabeculation in BPH is a predictor of the treatment outcome. Cystoscopy might be performed prior to invasive therapy to guide the urologist in choosing an operative approach.