Objectives: to assess the safety and efficacy of bipolar plasma kinetic energy in management of benign prostatic hyperplasia in patients on oral anticoagulant therapy and/or platelet aggregation inhibitors. Materials and Methods: Ninety-one patients were recruited and underwent plasmakinetic enucleation and resection of the prostate (PKERP) while they were receiving platelet aggregation inhibitors (PAIs) (Aspirin, 56 patients; clopidogrel, 3; aspirin and clopidogrel, 11 patients). Fifteen patients were receiving the oral anticoagulant (OA) drug peri-operatively while another 6 patients were on dual PAIs and OA. The primary outcomes were the peri-operative morbidity and mortality rates. The secondary ones were functional outcomes including maximum flow rate (Qmax), IPSS scores, and post voiding residual urine (PVRU). Results: Mean age of the patients was 65± 5.9 years, pre-operative adenoma volume was 80.9 ± 30.4 gm and the operative time was 67± 23 minutes. No patient developed peri-operative serious cardiovascular complications. The duration of Hospital stay was 1.79±1 day and the post-operative catheterization time was 1.14 ± 0.76 day. Hemoglobin drop was 0.74 ±0.61 g/dl, blood transfusion rate was 2.2% and clot retention rate was 2.2%. The postoperative Qmax was 18.6 ±4.37 ml/sec as compared to7.2 ± 3.2 ml/sec pre-operatively (P