Objective：To investigate the clinical efficacy and safety of holmium laser enucleation of the prostate（HoLEP） in the treat－ment of benign prostatic hyperplasia（BPH） with acute urinary retention（AUR）. Methods：A retrospective analysis was performed in 128 patients with BPH who underwent HoLEP in our hospital from February 2016 to February 2018，including 40（31.25%） patients with AUR（AUR group） and 88（68.75%） patients without AUR（non-AUR group）. According to the number of urinary retention episodes，the AUR group was divided into two subgroups：subgroup A（≤1 time，n=25） and subgroup B（>1 time，n=15）. The basic information，perioperative data，and postoperative follow-up parameters were compared between the AUR group and the non-AUR group and between the subgroup A and the subgroup B. Results：Compared with the non-AUR group，the AUR group had significant－ly higher urinary white blood cell positive rate，urine culture positive rate，prostate-specific antigen level，and International Prostate Symptom Score（IPSS）（P<0.05），a significantly longer operation time（P<0.05），and a significantly lower hemoglobin level（P<0.05）. There were no significant differences in change in hemoglobin level，catheter indwelling time，length of hospital stay，and incidence rate of perioperative complications between the two groups（P>0.05）. After surgery，both groups had significantly decreased post-void－ing residual（PVR），IPSS，and quality of life（QoL） score（P<0.05） and a significantly increased maximum urinary flow rate（Qmax）（P<0.05）. There were no significant differences in perioperative data and IPSS，QoL score，PVR，and Qmax at 6-month follow-up after surgery between the subgroup A and the subgroup B（P>0.05）. Conclusion：HoLEP is safe and effective in the treatment of BPH with AUR. The number of urinary retention episodes has no effect on the surgical outcome.