Purpose: To clarify the usefulness and safety of finasteride in the treatment of patients with benign prostatic hyperplasia (BPH) compared to placebo group or controls. Methods: In a meta-analysis, PubMed and Web of Science were searched to include relevant studies. The results were combined with a random effect model. Publication bias was evaluated using Egger regression asymmetry test. Results: Fourteen publications involving 17,364 patients were included in the study. Pooled results indicated that International Prostate Symptom Score (IPSS) in the finasteride group was lower [weighted mean difference (WMD) = -0.77, 95% Cl= -0.97 to -0.57] compared to the placebo group. The usefulness of finasteride was higher in total prostate volume (TPV) [WMD= 0.13, 95%Cl= 0.00 to 0.26] but lower in serum DHT [WMD= -1.18, 95%Cl= -1.51 to -0.86] when compared to the placebo group. Drug-related adverse event was higher in the finasteride treatment group when compared to placebo group [summary RR= 1.95, 95%Cl= 1.31-2.90]. Conclusion: Finasteride could improve the symptom score (IPSS and TPV) and reduce serum DHT. However, the potential adverse events, especially the drug-related adverse events in Finasteride treatment should be attention.