Benign prostatic hyperplasia(BPH) is most common urological disease among the elderly and it is the main cause of lower urinary tract symptoms(LUTS). This, descriptive, cross sectional study aims to determine the prevalence of BPH–associated LUTS in the eastern province of Saudi Arabia. The well–known international prostate system score (IPSS) was distributed to different hospitals in Dammam, Khobar, Al Qatif, and Al Hasa from the period of August 2016 through January 2017. A total of 88 participants filled the assessment tool questionnaire. All participants were male above 40 years of age. The total score of IPSS was 47.7% in participants who experienced moderate to severe LUTS. According to our result, nocturia seemed to be the most bothersome symptom (18.9%). 40% of all participants reported being either mostly dissatisfied or unhappy based on the quality of life (QOL) question. There was a strong relationship between our IPSS score and QOL question (r = 0.658, P = 0.001).  Our study reported a relatively high incidence of BPH–associated LUTS in the eastern region of Saudi Arabia. increased public awareness and a larger number of treatment options are needed to appropriately manage these symptoms and their consequences.