Background: Benign  prostatic hyperplasia (BPH)  is a noncancerous increase of  the size of the prostate gland. The two main medication classes for BPH management are alpha blockers  and 5α -reductase inhibitors .Urinary bladder stones account for 5% of all urinary stone disease. Lithotripsy with the holmium: YAG laser started with making small perforations on the stone surface. the laser fiber should be moved over the surface of the stone vaporizing the stone rather than fragmenting it till fragments become small enough to pass spontaneously or can be safely retrieved. The aim: This study was conducted to investigate the outcomes of Cystolithotripsy  with medical Treatment for Benign Prostatic Hyperplasia as an option for treatment of  Patients with Bladder Stone and Benign Prostatic Hyperplasia. Methods: prospective short term cohort study. 44 Patients with  urinary bladder stone and benign prostatic hyperplasia BPH who are programmed for endoscopic removal of bladder stone with subsequent medical management of BPH, including alpha-blocker  (Silodosin 8mg).from January 2017 – June  2017. All laboratory investigation within normal level no renal Hydronephrosis detected by radiological imaging and no malignancy in urinary bladder. Results: In our study shows significant improvement in IPSS which started 17.89±2.35 preoperative to 8.48±0.84 after six months, also significant improvement in PVR which started 90.62±.13.30 Before operation to become 27.27±14.3 After operation and lastly significant  improvement in Q-max which started 11.93±1.64 Before operation to become 16.46±0.77 after six month. Conclusion: Medical treatment of benign prostatic hyperplasia after endoscopic  removal of bladder stone  is an appropriate option for managing patients with bladder stone and benign prostatic hyperplasia. Lithotripsy with Holmium: YAG laser is an appropriate line in management of bladder stone associated with Benign prostatic hyperplasia.