A meta-analysis was recently published based on six randomized clinical trials of at least one year duration involving finasteride 5 mg and placebo in the treatment of men with clinical benign prostatic hyperplasia (BPH). In a pooled analysis, mean improvement in symptoms and urinary flow rate with finasteride were found to increase with increasing prostate size. This article reviews the previous publication of this meta-analysis, which indicated prostate volume is a key predictor of outcomes with finasteride treatment and suggested that finasteride is most effective in men with large prostates.