Objective: To determine if intravesical protrusion of the prostate (IPP) is a predictor of acute urinary retention. Patients and Methods: In a prospective study, men (aged >50 years) with lower urinary tract symptoms were evaluated using the 1) international prostate symptoms score (IPSS), 2) prostate specific antigen (PSA), 3) prostate volume and age. The patient bladder was filled with 200 ml normal saline via foley catheter. IPP was measured using transabdominal ultrasound. The degree of protrusion was classified as Grade 1: 5 mm or less; Grade 2: 6 to 10 mm; and Grade 3: > 10 mm. Urine flow rate and post void residual urine were recorded after catheter removal. Urinary retention was established if the patient failed to establish satisfactory urination, post-void residual urine greater than 100 ml, and urine flow rate less than 10 ml/sec. Results: A total of 64 patients were enrolled in the study but only 56 patients were included in the study. Of the five parameters considered, only intravesical prostate protrusion (p = 0.01405914) and IPSS (p = 0.00578724) had a significant relationship with acute urinary retention. Conclusion: The IPP significantly predicts acute urinary retention; grade 3 IPP had more tendency to have acute urinary retention. The other contributing predictor of urinary retention is the IPSS.