This study aimed to investigate differences in healthcare service utilization between patients with and those without benign prostatic hyperplasia (BPH) using Taiwans National Health Insurance population-based database. A total of 7413 patients with BPH and 7413 age-matched patients without BPH were included. The outcome variable was 1-year utilization of healthcare services including the number of outpatient visits, inpatient days, and the costs of outpatient and inpatient treatments. In addition, we separated healthcare services into urology services and nonurology services for analysis. We found that as to the utilization of outpatient urological services, patients with BPH had more outpatient services (7.84 vs 0.52, P < 0.001), higher outpatient costs (US$372 vs US$34, P < 0.001), a longer length of inpatient stay (0.55 vs 0.11, P < 0.001), higher in-patients costs (US$149 vs US$32, P < 0.001), and higher total costs (US$521 vs US$67, P < 0.001) than the comparison group. As for nonurological services, patients with BPH also had more outpatient services (49.11 vs 24.79, P < 0.001), higher outpatient costs (US$1794 vs US$1014, P < 0.001), a longer length of in-patient stay (3.72 vs 2.04, P < 0.001), higher inpatient costs (US$874 vs US$486, P < 0.001), and higher total costs (US$2668 vs US$1500, P < 0.001) compared to comparison patients. We also found that the average total cost was about 2-fold greater for patients with BPH than comparison patients. We concluded that patients with BPH had higher healthcare utilization than comparison patients without BPH.