Purpose: To study the clinical and epidemiological aspects of benign prostatic hypertrophy at the Koutiala reference health center. Patient methods: This is a prospective study from April 2016 to April 2017, 13 months in total. All patients in whom the clinical examination and ultrasound made the diagnosis of prostate adenoma and in whom the diagnosis was confirmed at surgery were included in this study. Results: The frequency of benign prostatic hypertrophy was 23.81%; it occupied first place among surgical uropathies with 54.94% and took second place among all surgical pathologies with 29.6% of cases. The average age of our patients was 71 years. The age group 61 – 75 was the most affected with a frequency of 59%. Acute retention of urine comes first among the reasons for consultations with a rate of 58%. Ultrasound has been the reference examination for the diagnosis of this pathology. It was performed in all our patients. The surgical pathologies most associated with prostate adenoma were inguinal hernia, 6 cases (6%). The treatment was surgical in 100% of the series, via the transvesical route using the Freyer Hryntchak technique. The pathological examination of the surgical specimens detected one case of prostate adenocarcinoma,1%. Post-operative outcomes were simple in the majority of cases,86%. 70% of patients had a hospital stay of 5 days, the average was 8 days with extremes of 4 and 33 days. The mortality rate was 4.17%. Conclusion: Upper prostatic adenomectomy remains the main technique for surgical management of BPH in Mali and in our center in particular with low postoperative morbidity and mortality.