Introduction: The aim of this study was to assess relations between total ghrelin concentrations, PSA levels and other metabolic parameters in patients with Benign Prostate Hyperplasia (BPH) and in patients with BPH and coexisting Type 2 Diabetes (T2D) due to estimate its diagnostic value. Material and method: Altogether, 21 patients with BPH, 22 patients with BPH and coexisting T2D and 24 control subjects were enrolled in the study. All participants underwent a comprehensive medical evaluation including clinical history and urological examination. The following variables were determined for each subject: total ghrelin, total Prostate-Specific Antigen (PSA), fasting glucose, insulin, C-peptide, glycosylated hemoglobin (HbA1c), triglycerides, total cholesterol, high-density and low-density lipoprotein cholesterol, transaminases and creatinine. Results: Diabetic men with BPH had similar PSA levels as control men without BPH. In addition PSA concentrations were reduced in with coexisting T2D when compared with non-diabetic patients with BPH. There were no statistically significant differences in total ghrelin concentrations between diabetics with BPH as well as non-diabetics with BPH and controls, however, in non-diabetic patients with BPH there was significant positive correlation between serum PSA and total ghrelin concentrations (R=0.638; P=0.002). Discussion: We conclude that reduced concentration of PSA in subjects with coexisting T2D may delay the diagnosis and treatment of BPH in these patients. Further studies are needed to assess the diagnostic role of serum ghrelin levels in diabetic men with BPH.