Objective Intravesical prostatic protrusion (IPP) is a noninvasive parameter that can predict disease progression and development of complications in benign prostatic hyperplasia (BPH). This study was to determine the relationship between IPP and the presence of complications in BPH patients. Methods This was a cross‐sectional study of BPH patients at Enugu State University of Science and Technology Teaching Hospital, Enugu. Patients were assessed for acute urinary retention (AUR), chronic urinary retention (CUR), epididymoorchitis, hematuria, hernia, urinary tract infection (UTI), serum creatinine, and prostate‐specific antigen (PSA). They also had abdominal ultrasonography assessments for IPP, total prostate volume, bladder wall thickness (BWT), postvoid residual (PVR), hydronephrosis, bladder diverticulum, and urolithiasis using Sonoscape S11 with an abdominal‐probe frequency of 3.5 MHz. IPP was measured in millimeter and divided into <10 mm and ≥10 mm. Data were analyzed using SPSS version 21 and were subjected to 1‐way analysis of variance, chi‐square test, and Pearson correlation. The odds ratios of development of complications at an IPP cutoff of 10 mm were calculated. P < .05 was considered significant. Results A total of 118 patients with a mean age of 64.18 ± 10.96 years and a mean IPP of 14.29 ± 10.20 mm were included. Forty‐eight patients had IPP < 10 mm and seventy patients ≥10 mm. Patients with IPP ≥10 mm had significantly higher mean BWT, International Prostate Symptom Score (IPSS), PSA, and PVR (P ≤ .05) and significantly more AUR, CUR, hematuria, hydronephrosis, and UTI (P ≤ .01). Conclusion Patients with IPP ≥ 10 mm have a significantly higher incidence of some complications.