The article presents the features of the tactics of conservative management of elderly patients with benign prostatic hyperplasia (BPH). A group of men with benign prostatic hyperplasia (32 patients), whose mean age was 67 years old, was under observation. The total duration of conservative treatment and follow-up ranged from 1.5 to 4 years. The scope of the preliminary examination included an extended biochemical test, all patients underwent 2-day uroflow monitoring, ultrasound examinations of the urinary system, measurement of the size of the prostate and residual urine. The efficiency of conservative combination therapy was evaluated using the IPSS table, urination diaries and home uroflow monitoring. As a result of the treatment with 5-alpha-reductase, alpha1-blockers, lipoic acid and vitamins, there was a significant decrease in the severity of clinical symptoms and leveling of dysfunction of the lower urinary tract.