Background: Premature ejaculation (PE) is a common sexual problem, many epidemiological reports have shown that approximately 20–30% of men have complaints of PE. Objective: The aim of this study was to evaluate the effectiveness of silodosin 4mg in treatment of premature ejaculation. Patients and methods: This study was conducted on 160 subjects with premature ejaculation. The patients were recruited from Dermatology and Andrology Outpatient Clinics in Al-Azhar University Hospitals . Results: According to our results, there is highly statistically significant difference (p-value < 0.001) between patient group (559.3 ± 159.9) and control group (248.4 ± 83.7) as regard intravaginal ejaculatory latency time (IVELT) post-treatment (p-value < 0.001). Also, we found highly statistically significant difference (p-value < 0.001) between premature ejaculation profile questionnaire (PEPQ) pre- and post-treatment in patients' group. As silodosin caused improvement of control over ejaculation, satisfaction with sexual intercourse, personal distress related to ejaculation and interpersonal difficulty. At the end of the study only 11 (13.75%) patients reported that they had a decreased semen volume as a side effect of silodosin, which disappeared completely after discontinuation of the drug. Conclusion: we found that, silodosin 4 mg is a promising idea in treatment of premature ejaculation, as it is effective, cheap, safe and available in Egyptian market. We recommend administration silodosin 4mg 2 hours before sexual intercourse for treatment of premature ejaculation.