Purpose: This study evaluated the safety and efficacy of photoselective vaporization of prostate using the 120 W High Performance System for management of symptomatic benign prostatic hyperplasia (BPH). Methods: We prospectively obtained data from 229 patients between January 2009 and December 2012. We evaluated the serum prostate specific antigen level, International Prostate Symptom Score (IPSS), prostate volume; maximum urine flow rate (Q(max)); and postvoid residual urine volume (PVR) in the patients at presentation and on follow-up at 1, 6, 12, and 24 months. The mean duration of the surgery, energy used, hospital stay, and intra- and postoperative complications were assessed. Results: The mean age of the patients was 71.2 +/- 9.6 years, and the mean preoperative size of the prostate was 59.41 +/- 28.1mL. The mean duration of the surgery was 47.35 +/- 16.14min, and the mean energy use was 184.39 +/- 101.3kJ. The mean time to removal of the urinary catheter was 21.45 +/- 11.06h, while the mean duration of hospital stay was 24.82 +/- 11.5h. The IPSS declined and mean Q(max) increased by over twofold within the first month. The PVR also declined significantly in all groups up to 6 months after the surgery and increased slightly thereafter. Urinary urgency and incontinence occurred in two patients, while four patients developed urinary strictures. Between 12 and 24 months after the surgery, four patients underwent repeat surgery. Conclusions: Our findings show that photoselective vaporization is safe and effective for the management of BPH and resulted in few complications. It yielded improvements in all parameters that were sustained even up to 2 years after the surgery.