: The association between periodontitis and benign prostatic hyperplasia (BPH) has been controversial. This study aimed to estimate the association between recurrent periodontitis episodes and the occurrence of BPH in an adult male population in Korea. : This study analyzed data from 79,497 matched cases and controls to examine the relationship between periodontitis and BPH, using Korean National Health Insurance Service-Health Screening Cohort data. Conditional logistic regression was used to calculate odds ratios (ORs) with 95% confidence intervals (CIs), adjusting for confounding factors. : The odds of BPH were significantly higher for participants with periodontitis ≥ 1 within 1 year (OR = 1.34, 95% CI = 1.31-1.37), particularly in low-income individuals (OR = 1.43, 95% CI = 1.38-1.48). Increased periodontitis frequency (≥2 or ≥3 within 1 year) and a CCI score ≥ 2 were associated with progressively higher odds of BPH, indicating that periodontitis may be a significant risk factor for BPH, with variations depending on socioeconomic and health status. : The occurrence of BPH was higher in participants with a history of recurrent periodontitis episodes, with stronger associations observed in those with low income or multiple comorbidities. Clinicians should be aware of the potential risk of BPH in patients with recurrent periodontitis episodes. This study's retrospective design, reliance on ICD-10 codes without details on disease severity, and focus on Korean citizens over 40 limit its ability to establish causality and generalizability to other populations and age groups, which should be considered when interpreting the findings.