Background <p>Advancements in surgical techniques have led to a shift in the types of procedures performed for BPH. This study aims to analyze trends in rates and outcomes of surgical procedures for BPH between 2008 and 2021.</p> Methods <p>Using the ACS-NSQIP database, patients who underwent BPH surgery between 2008 and 2021 were identified. Trends, baseline characteristics and perioperative outcomes were collected for transurethral resection of prostate (TURP), photo-vaporization of prostate (PVP), Laser enucleation of the prostate (LEP) and simple prostatectomy.</p> Results <p>A total of 99,291 BPH procedures were recorded, increasing from 850 in 2008 to 11,005 in 2021. TURP was the most performed procedure with rates rising from 56.1% in 2008 to 65.2% in 2021. PVP was the second most performed procedure, with rates decreasing from 41.6% in 2008 to 22.5% in 2021. LEP procedures were not recorded prior to 2011 after which the number increased from 82 (2.6%) procedures in 2011 to 971 (8.8%) in 2021. Simple prostatectomy had a relatively stable rate over the course of 14 years (1.8%-3.4%). Over time, a reduction in hospital stay (1.3 to 1.1 days, <i>p</i> &lt; 0.001), and an increase in operative time were observed (55&#xa0;min ± 31.81 to 66&#xa0;min ± 46.6, <i>p</i> &lt; 0.001).</p> Conclusions <p>There has been a noticeable shift in the surgical management of BPH between 2008 and 2021, with a clear trend favoring novel techniques. Utilizing these approaches has led to improvements in perioperative outcomes. Further research is necessary to evaluate long-term outcomes and cost-effectiveness of novel techniques.</p>