Inconsistency between reported findings on the association of prostate specific antigen (PSA) gene -158G/A polymorphism with benign prostatic hyperplasia (BPH) susceptibility need a meta-analysis to obtain a more accurate conclusion. A systematic search was conducted in electronic databases for the collection of eligible studies on PSA -158G/A polymorphism and BPH susceptibility. Pooled odds ratios (ORs) and 95% confidence intervals (95% CIs) were then calculated. 7 case-control studies with 758 cases and 752 controls were included into the present meta-analysis. The analysis results showed no significant relationship between PSA -158G/A polymorphism and BPH susceptibility in total analysis. Interestingly, after subgroup analyses based on ethnicity and source of control, the polymorphism reduced the susceptibility of BPH in Caucasian group (AA vs. GG: OR=0.47, 95% CI=0.25-0.89; allele A vs. allele G: OR=0.68, 95% CI=0.49-0.93), but it increased the disease susceptibility in Asian (AA vs. GG: OR=1.63, 95% CI=1.02-2.60; allele A vs. allele G: OR=1.37, 95% CI=1.03-1.83) and population-based (AA vs. GG: OR=2.39, 95% CI=1.07-5.38; allele A vs. allele G: OR=1.83, 95% CI=1.26-2.65) groups. PSA-158G/A polymorphism may be an inhibitor to the incidence of BPH in Caucasians, but it is likely to be a susceptible factor in Asians.