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Objective: To observe the levels of plasma adiponectin and to explore the relationship between the levels of plasma adiponectin and drug efficacy in geratic patients with benign prostate hyperplasia. Methods: 70 cases of geratic men with benign prostate hyperplasia in hospital, according to the International Prostate Symptom Score (IPSS) were divided into 3 groups, 12 cases of mild group, 30 cases of moderate group and 28 cases of severe group. Plasma adiponectin concentration was measured in these cases. The differences of adiponectin levels were compared among the groups. 57 cases with IPSS moderate and above were treated with medication. The levels of adiponectin and prostate volume reduced were compared between the different efficacy groups. Results: Plasma adiponectin levels were significantly reduced according to the severity of prostate symptom in the patients with benign prostatic hyperplasia ( P ＜0.001). Adiponectin levels correlateiy negatively with IPSS ( r ＝ －0.696, P ＜0.01). The levels of adiponectin were (8.16±2.03)mg/L in efficacy group and (6.85±1.92)mg/L in without efficacy group, and there were significant differences between two groups ( P ＝0.024).There were more obvious prostate volume reduced in the efficacy group than those in without efficacy group ( P ＜0.01). Conclusions: Adiponectin levels may reflect the severity of lower urinary tract symptoms (LUTS) in benign prostatic hyperplasia. The patients with low adiponectin levels have poor efficacy by medication treatment. The decrease of adiponectin may be involved in the pathogenesis of prostate hyperplasia.