Objectives: we assessed feasibility of transrectal prostatic nerve block.Materials and method: 10cc Xylocaine (lidocaine) 2% and 10cc marcaine (bupivacaine) were used. Pain score determination by using a 10-point linear analog pain scale. Results: seven patients were included. The mean age was 66.4 years, ranging from 53 to 76 years. The adenoma ranged from 3cc to 12cc with a mean volume of 7cc. Bladder neck incision was done under local anesthesia in six patients of the study (85.7% of the study) while the last one general anesthesia was required from the start. Four patients did not need general anesthesia at all and bladder neck incision was done completely with local anesthesia only (57.1% of cases of the study). General anesthesia was required in two patients after 30 minutes of resection with local anesthesia. During the procedures, there was an increase of 46 mmHg in the mean blood pressure during the procedure. The mean pain score was 1, 2.3 and 3.4 during instrumentation, bladder distention and incision respectively. There were no complications. Conclusion: This procedure is safe and feasible in high surgical risk patients and small prostate less than 20 cc. Bladder pain caused by bladder distention can be prevented by minimization of bladder distention and rapid procedure done by highly experienced urologist and instillation of local anesthetic agent intravesical. Intravenous analgesia and sedation from the beginning of the procedure is recommended to enhance patient acceptance of this mode of anesthesia.