Objectives: To compare the prevalence of preoperative co-morbid factors and complications of transurethral resection of prostate (TUR-P) in patients with normal and non-dialysis requiring elevated serum creatinine levels. Methods: The records of 357 consecutive patients with IPSS≤20, serum creatinine level ≤ 3 mg/dl, residual urine volume ≤ 300 ml and with no upper urinary tract dilatation or evidence of prostate cancer that underwent TUR-P were retrospectively evaluated. 60 patients who did not fulfill the inclusion criteria were excluded. The preoperative Na, K, creatinine levels and the early changes observed in these parameters after TUR-P of the patients with normal (Group1, n = 272) and elevated (Group2, n = 25) serum creatinine levels, as well as the preoperative baseline data and postoperative complications were compared. Results: Preoperative PSA, serum urea, creatinine and K levels were significantly higher in group2. No significant differences were observed between early and late postoperative complications of the two groups. Co-morbid diseases were significantly more common in group2. No progression in renal failure or de novo need for hemodialysis was observed in group2. Conclusions: TUR-P can be safely performed in BPH patients with mild serum creatinine elevations (1.6-3 mg/dl) and moderately increased prostate volumes without additional morbidity and mortality. © 2012, SAGE Publications. All rights reserved.