Most men over 50 experience some lower urinary tract symptoms of nocturia, poor stream, urgency and frequency for urination, due to hyperplastic enlargement of the prostate (benign prostate hyperplasia, BPH). BPH is thought to be a disease with multiple aetiologies including hormone signalling, disruption of proliferation and apoptosis dynamics and chronic inflammation with changes in the morphology and phenotype of the prostate stroma. It has been proposed, recently, that stromal stem cells in prostate may be caused by the development of BPH. This review focuses on this putative role of stromal stem or stem-like cells in the development of BPH and assesses the potential of targeting the stem cells for the treatment of BPH.