Background: Overactive bladder (OAB) is a syndrome characterized by the presence of urgency, with or without urinary incontinence usually with increased daytime or night-time frequency. Overactive bladder is a very prevalent condition in both female and male patients, and it is more common in older adults compared with the general population. This study amid to evaluate the safety and efficacy of mirabegron compared to propiverine for managing storage symptoms in benign prostatic hyperplasia patient. Methods: This clinical prospective, randomized comparative study was to compare the clinical efficacy and safety of Mirabegron at Urology outpatient clinic, Faculty of medicine, Zagazig University from October 2018 and April 2019. 60 patients were randomly allocated in two groups; Group (A): Patients receive (mirabegron 50mg) once daily for three months. Group (B): Patients receive (Propiverine HCL 30mg) once daily for three months. Results: Propiverine and mirabegron exert similar efficacy for OAB symptoms in patients with BPH. However mirabegron seems more efficacious than Propiverine. It also represents a reasonable alternative to antimuscarinics as well as a good option for patients who should avoid potential antimuscarinic adverse effects. Conclusions: Mirabegron can be considered as adrug with the better balance between efficacy and tolerability than Propiverine.