PURPOSE: Air pollution has been an important risk factor for human health. However, little is known about the impacts of air pollutants on benign prostatic hyperplasia (BPH) in men. We aimed to explore the association of long-term exposure to air pollutants with BPH among men. METHODS: We leveraged the nationally representative data from the China Health and Retirement Longitudinal Study, a total of 8,826 participants aged 45 years and above from 125 Chinese cities were enrolled in 2015. Annual fine particulate matter (PM), coarse particles (PM), nitrogen dioxide (NO), sulfur dioxide, carbon monoxide, and ozone were estimated using satellite-based models. Multivariate logistic regression models were used to assess the risk of BPH associated with air pollutants. The restricted cubic spline model was performed to explore the exposure-response relationships with BPH. RESULTS: Of the 8,826 participants (mean age: 60.3 years), the prevalence of BPH was 14.5%. Each 10 µg/m rise in PM (odds ratio 1.04, 95% confidence intervals: 1.01-1.07) and PM (1.06, 1.02-1.10) were associated with prevalent BPH. Compared with the lowest quartile levels, higher PM and PM exposure were related to an increased risk of BPH. There were non-linear relationship between PM and NO exposure with prevalent BPH. The association with BPH was more pronounced in participants who were overweight/obesity. CONCLUSION: This study suggests that long-term air pollutants exposure, especially for PM and PM, is associated with BPH among middle-aged and older men. Our findings provide epidemiological evidence for policymakers and researchers to improve prostate health by reducing air pollution.