The purpose of this study was to determine the efficacy and safety of dutasteride compared with finasteride, used for the treatment of benign prostatic hyperplasia (BPH). Pertinent studies were identified by searching of PubMed and Web of Science. The random effect model was used to combine the results. Both direct comparison using traditional meta-analysis method and indirect comparison using network meta-analysis method were performed. Twenty-one articles involving a total of 29,094 patients were included in this network meta-analysis. Pooled data demonstrated a significantly reduction in International Prostate Symptom Score in the dutasteride group compared with finasteride group [weighted mean difference (WMD) = -1.80, 95% confidence interval (CI), -2.90 to -0.11]. The treatment effects of dutasteride compared with finasteride were not significant in peak urinary flow (Q(max)) (WMD = 0.76, 95% CI, -0.67 to 2.00) and total prostate volume (WMD = -7.6, 95% CI, -21 to 6.6). Also, there is no significant association between dutasteride and finasteride of the safety for the treatment of BPH. Our results suggested that there were no statistically significant differences in the treatment of symptomatic BPH among dutasteride compared with finasteride except that dutasteride can improve BPH symptoms measured by International Prostate Symptom Score.