Objective?To investigate the feasibility, effectiveness and practicality of transurethral enucleation plus opreative rotating cutter for large size benign prostatic hyperplasia (BPH).?Methods?65 large BPH patients were divided into 2 groups randomly from February 2014 to February 2016. One group, 30 cases, patients were performed rotating cutter operation: conducted ransurethral enucleation the hyperplastic glands of prostate and pushed into the bladder, and thereafter operative rotating cutter were used to comminute and aspirate the enucleated tissue. The other group, 35 cases, patients were performed conventional TURP.?Results?Satisfactory surgical results were obtained in all cases. Time of rotating cutter operation was shorter than TURP operation (48.5 ± 17.3) min vs (75.6 ± 21.4) min, t = 5.55, P = 0.000; Blood loss of rotating cutter operation was less than TURP operation (51.8 ± 14.6) ml vs (102.3 ± 32.4) ml, t = 7.87, P = 0.000. The volume of resected tissues of rotating cutter operation was more than TURP operation (78.3 ± 15.5) ml vs (61.8 ± 12.9) ml, t = 4.69, P = 0.000. Postoperative IPSS, Qmax, Residual urine between the two groups have no significant difference (P > 0.05). Postoperative indexs of these were significant different compared with preoperative ones (P < 0.05).?Conclusion?Transurethral enucleation plus opreative rotating cutter for large BPH take the shorter operative time and has less blood loss but more volume of resected tissues than TURP.