Benign prostatic hyperplasia (BPH) is one of the most common benign diseases that cause urinary disorders in middle-aged and elderly men. With the aging of our population, the incidence of prostatic hyperplasia is on the rise and has become a major problem for older men, seriously affecting their quality of life and increasing the chances of complications. High-intensity focused ultrasound (HIFU) extracorporeal therapy can be one of the safe and effective ways to treat high-risk prostate hyperplasia without surgical trauma. The exact mechanism by which BPH occurs is unclear and may be caused by a balanced disruption of epithelial and mesenchymal cell proliferation and apoptosis. The associated factors are: androgens and their interaction with estrogen, prostate mesenchymal-adenoepithelial cell interaction, growth factors, inflammatory cells, neurotransmitters and genetic factors. Benign prostatic hyperplasia is mainly characterized by histological hyperplasia of the interstitial and glandular components of the prostate, anatomical enlargement of the prostate, clinical symptoms dominated by lower urinary tract symptoms, and urodynamic obstruction of the bladder outlet. The main clinical symptoms are: increased nocturnal urination, intermittent urination, straining to urinate, interruption of urination, incomplete urination, thinning of the urine line, waiting for urination and even complications of acute urinary retention. The diagnosis of BPH was confirmed by rectal examination, urine routine, serum PSA test, ultrasonography, and urine flow rate examination. The combination of serious cardiopulmonary disease and diabetes mellitus is also a contraindication to surgery and is a clinical high-risk patient for BPH of the prostate. The treatment of benign prostatic hyperplasia consists of four main categories: watchful waiting, drug therapy, minimally invasive therapy and surgical treatment. The purpose of treatment is to improve the patient’s quality of life while protecting kidney function. The choice of specific treatment should be based on the severity of the patient’s symptoms, combined with various ancillary tests, local medical conditions and the patient’s compliance. The traditional open prostate removal surgery is more thorough and effective, but it is not suitable for elderly patients with high-risk BPH. The HIFU method is to focus high-energy ultrasound on the hyperplastic prostate tissue from outside the body under the real-time monitoring of ultrasound positioning, using the aggregation and energy penetration of ultrasound to focus the high-energy ultrasound emitted from outside the body on the lesion in the body, using the high temperature effect and cavitation effect produced by the focal point to cause vacuolar degeneration, coagulative necrosis and then gradual dissolution and absorption or fibrosis. It has been shown that High Intensity Focused Ultrasound (HIFU) can effectively cause coagulative necrosis in isolated human prostate tissue. The HIFU treatment can not only stop the growth of prostate tissue, but even make it atrophy and become smaller, thus relieving the symptoms of urinary obstruction, in order to achieve the clinical treatment effect. The FEP-BY series of high-energy focused ultrasound machines for high-intensity focused ultrasound (HIFU) treatment is “non-invasive” and painless, and does not require any anesthesia. After the treatment, patients are regularly followed up to observe the clinical symptoms, signs and ultrasound imaging changes of the tumor.