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Inflammation has been suggested to be involved in the pathogenesis of benign prostatic hyperplasia (BPH). We studied the prevalence of inflammation and BPH in Asian and Caucasian men on prostate glands ( n = 320) obtained during autopsy in Moscow, Russia (Caucasian men, n = 220), and Tokyo, Japan (Asian men, n = 100). We correlated the presence and grade of acute inflammation (AI) or chronic inflammation (CI) and BPH. AI, CI, and histologic BPH were analyzed in a blinded fashion using a grading system (0–3). We used the Cochran-Armitage test for associations between the degree of BPH and clinical variables and proportional odds logistic regression models in multivariable analysis. Histologic BPH was observed in a similar proportion of Asian and Caucasian men ( p = 0.94). CI was found in > 70% of men in both the Asian and Caucasian groups ( p > 0.05). Higher BPH scores were associated with more CI ( p < 0.001). In multivariate analyses, individuals with CI were 6.8 times more likely to have a higher BPH score than individuals without ( p < 0.0001). Men included in this study presented at the hospital and their symptomatic status was not known. The prevalence of CI and BPH on autopsy is similar in Asian and Caucasian men despite very different diet and lifestyle. CI is strongly associated in both groups with BPH. Patient summary In this study, we looked at the prevalence of inflammation and benign prostatic hyperplasia (BPH) on autopsy in Asian and Caucasian men. We found chronic inflammation in > 70% of men on autopsy. More chronic inflammation was associated with more BPH. [ABSTRACT FROM AUTHOR]