【Objective】 To compare the clinical efficacy of transperineal prostate laser ablation (TPLA) and transurethral resection of the prostate (TURP) in the treatment of benign prostatic hyperplasia (BPH). 【Methods】 A total of 60 BPH patients diagnosed during Oct. 2021 and Oct. 2022 at Tangdu Hospital were selected as the research subjects and randomly divided into the TPLA group (n=30) and TURP group (n=30). The intraoperative bleeding volume, operation time, catheter indwelling time, length of hospital stay, postoperative sexual dysfunction, and surgical related complications were compared between the two groups. The international prostate symptom score (IPSS), international index of erectile function-5 (IIEF-5), maximum urinary flow rate (Qmax), quality of life score (QoL), postvoid residual (PVR) and prostate volume (PV) were compared between the two groups before surgery and 1, 3, and 12 months after surgery. 【Results】 The TPLA group had significantly less intraoperative bleeding volume, shorter operation time and length of hospital stay compared to the TURP group, but longer catheter indwelling time (P<0.05). Both groups showed significant improvement in IPSS and Qmax 1, 3, and 12 months postoperatively compared to preoperative (P<0.05), the IPSS of the TPLA group was significantly higher than that of the TURP group 1 and 3 months after surgery (P<0.05); the Qmax of TPLA group 1, 3, and 12 months after surgery was lower than that of the TURP group (P<0.05). The IIEF-5 score was significantly better in the TPLA group than in the TURP group after surgery (P<0.05). The postoperative QoL, PV, and PVR levels in both groups improved after surgery (P<0.05), the QoL of the TPLA group was lower than that of the TURP group 1 and 12 months after surgery (P<0.05), the PV and PVR of the TPLA group were higher than those of the TURP group 1, 3, and 12 months after surgery (P<0.05). The incidence of surgery-related complications (3.33% vs. 26.67%) and postoperative sexual dysfunction (3.33% vs. 36.67%) in the TPLA group were lower than those in the TURP group (P<0.05). 【Conclusion】 TPLA shows significant efficacy in treating BPH with minimal impact on the sexual function. It provides a new approach for BPH patients and can serve as an effective complementary method in clinical practice.