This US national survey evaluated beliefs and attitudes towards the enlarged prostate (EP) and its treatment among the men of a national sample aged ≥50 years in the US (400 with and 700 without EP), and a national sample of 100 primary care doctors and 100 urologists. The principal risk of EP was considered to be acute urinary retention among the majority of physicians, while the majority of patients believed it to be prostate cancer. In contrast to physicians’ beliefs, the majority of patients with moderate-to-severe symptoms are more concerned with long-term effects of EP than acute symptoms. Furthermore, they are willing to wait up to 3 months for symptom relief if treatment of the underlying condition is achieved. Doctors and patients agree that most patients want to avoid surgery but only 18% of surgery patients were told about drugs that could reduce the risk of surgery. These findings demonstrate significant differences between the beliefs and attitudes of patients and physicians towards EP.