Objective To compare the effect and safety of traditional electroresection of prostate and prostate plasma enucleation of benign prostatic hyperplasia (BPH) in the elderly. Methods 120 elderly patients with BPH who received surgical treatment in our hospital from January 2019 to August 2022 were selected retrospectively as the study objects. According to the surgical methods, they were divided into the traditional prostate resection (TURP) group of 59 cases and the prostate plasma enucleation (TUEP) group of 61 cases. The operation time, weight of resected tissue, amount of bleeding, extubation time, postoperative complications, IPSS score, QOL score, IIEF-5 score, maximum urinary flow rate (Qmax) and residual urinary volume (PVR) of bladder were compared between the two treatment groups. Results The operation time, catheter indwelling time, bladder flushing time and hospitalization time of TUEP group were shorter than those of TURP group, and the amount of bleeding was less than that of TURP group, the difference was statistically significant (P<0.05). The total incidence of postoperative complications in TUEP group was lower than that in TURP group, and the difference was statistically significant (P<0.05). There was no significant difference in preoperative urodynamic parameters between the two groups (P>0.05). Three months after operation, Qmax in both groups was significantly higher than that before operation (P<0.05), and there was no significant difference between the two groups (P>0.05). PVR in the two groups decreased significantly compared with that before operation, and that in the TUEP group decreased significantly compared with that in the TURP group (P<0.05). There was no significant difference in IPSS and QOL scores between the two groups before operation (P>0.05). Three months after operation, IPSS and QOL scores in both groups were significantly lower than those before operation, and IPSS scores in TUEP group decreased more significantly, with a statistically significant difference (P<0.05). Conclusion Compared with traditional TURP, TUEP treats elderly BPH with definite clinical effect, less trauma, fast recovery, and can effectively restore bladder function, significantly improve the quality of life of patients with less complications, which is worthy of promotion and application