Transurethral resection of prostate (TURP) still remains the “gold standard” surgical treatment for benign prostatic hyperplasia (BPH). In recent years, holmium laser enucleation of prostate (HoLEP) gets more and more popularity in the world. Our objective is to compare the efficacy and safety of HoLEP and TURP for BPH. Eleven studies met our eligibility criteria including 1339 patients. The prostate sizes of the all included studies were smaller than 100 g. Overall, in patients with small to mid-sized prostates, HoLEP offers safer clinical outcomes with less blood drop and potentially better long-term relief of bladder outlet obstruction.