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Objective: A large prostate size (＞80 mL) of benign prostatic hyperplasia (BPH) is technically challenging to treat surgically.This study aimed to investigate the safety and efficacy of super-selective prostatic artery embolization (PAE) for the treatment of urinary retention caused by large BPH.Methods: A total of 21 patients with urinary retention,indwelling urinary catheter,or suprapubic cystostomy as a consequence of giant BPH (prostate volume[PV]＞ 80 mL) who sought treatment between January 2013 and December 2017 were enrolled.A microcatheter (1.9-2.7 Fr) and a “two-step embolization” combining 50-μm and 100-μm polyvinyl alcohol embolization particles were used in all patients.International Prostate Symptom Score (IPSS),quality of life (QoL),PV,and prostate-specific antigen (PSA) were evaluated at 3,6,and 12 months post-PAE.Clinical success was defined as removal of urinary catheter or suprapubic cystostomy and ability to void spontaneously.Result: The clinical success rate was 95.2％ (20/21).Compared with pre-procedural values,IPSS,QoL,PV,and PSA showed statistically significant differences at 3,6,and 12 months post-PAE (P ＜ 0.05).There were no serious complications after PAE.Conclusions: PAE was safe and effective for the treatment of urinary retention caused by large BPH in patients without surgical treatment options.