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Benign prostatic hyperplasia is one of the most common diseases of elderly men and is often, but not exclusively, associated with lower urinary tract symptoms. The primary aim of therapy is to improve lower urinary tract symptoms and quality of life and, second, to prevent complications, such as urinary retention, upper urinary tract dilatation and infection. α1-blockers are used as first-line therapy. Today, there are different α-blockers available. They have comparable clinical effectiveness; however, they differ in their tolerability profiles. The α1A-receptor selectivity may be one reason for the difference in the tolerability profile. A new very selective α1A-blocker, named silodosin, is now available in Europe. This article gives an overview of the chemical structure of silodosin, its pharmacokinetics, metabolism, interaction with other drugs and pharmacodynamics. In the second half of this article, the clinical efficacy of silodosin and its adverse events are highlighted and compared with other available α1-blockers.