The present study was an updated meta-analysis that aimed to confirm the efficacy and safety of dutasteride (0.5 mg) and finasteride (5 mg) in treating males with benign prostatic hyperplasia (BPH) over a treatment period of at least 6 months. Randomized controlled trials were retrieved using the MEDLINE, EMBASE and the Cochrane controlled trials register databases. The references of the associated articles were also searched. A systematic review was performed by using the preferred reporting items for systematic reviews and meta-analyses. The data were analyzed with RevMan v5.3.0. A total of six articles including 2,041 participants were studied. The analysis demonstrated a significantly greater decrease in international prostate symptom score [IPSS; mean difference (MD), -0.86; 95% CI, -1.62 to -0.11; P=0.02] and prostate-specific antigen (PSA; MD, -0.13; 95% CI, -0.26 to -0.01; P=0.03) in the dutasteride group compared with that in the finasteride group, whereas no significant differences were observed in prostate volume (PV; P=0.64), maximum urine flow rate (Qmax; P=0.29) and post-void residual volume (PVRV; P=0.14). With regard to safety assessment, including any adverse event (P=0.66), decreased libido (P=0.39) and impotence (P=0.17), there was no significant difference between dutasteride and finasteride. In conclusion, in patients with BPH, dutasteride produced a greater decrease in IPSS and PSA compared with finasteride, whereas no significant differences were identified in PV, Qmax and PVRV. The two drugs appeared to have similar rates of adverse effects, particularly with regard to sexual dysfunction.