Many urologists have a high regard for the usefulness of transurethral microwave therapy (TUMT) in treating patients with lower urinary tract symptoms caused by benign prostatic hyperplasia. This therapy has been examined clinically in many centers throughout the world. The rationale for its effect on symptoms is unlike many of the other so-called minimally invasive treatment modalities. The improvement in symptoms and voiding function is greater with transurethral microwave thermotherapy than with drug therapy, and the associated morbidity is low. It also offers greater versatility than drug therapy, allowing patients with severe baseline symptoms and small prostates to be treated successfully. In addition, there has been an evolution in the technology of TUMT from low-energy to high-energy application indicating that this technique has a future in the treatment of lower urinary tract symptoms.