Objectives:　To　investigate　the　safety　and　efficacy　of　prostatic　artery　embolization　(PAE)　in　the　treatment　of　lower　urinary　tract　symptoms　(LUTS)　caused　by　benign　prostatic　hyperplasia　(BPH),　and　to　investigate　predictors　of　clinical　success　of　PAE.　Methods:　A　retrospective　analysis　was　used　to　collect　107　patients　[median　age　81.0　(73.0,85.0)]　with　BPH-related　LUTS　treated　with　PAE　from　September　2014　to　February　2022　in　a　hospital.　Repeated　measurement　ANOVA　was　used　to　compare　the　efficacy　evaluation　indicators　at　different　times　before　and　after　PAE.　Univariate　and　multivariate　analyses　were　used　to　identify　potential　predictors　of　PAE　clinical　success　and　establish　the　optimal　joint　prediction　model.　The　Receiver　Operating　Characteristic　curves　of　the　quantitative　predictors　and　multivariate　model　prediction　probability　values　significantly　correlated　with　clinical　success　were　plotted.　Results:　Of　the　107　cases,　103　(96.3%)　successfully　underwent　PAE.　The　International　Prostate　Symptom　Score　(IPSS)　decreased　from　a　baseline　mean　of　24.94　to　10.19　(P　＜　0.05)　3　months　after　PAE,　and　the　mean　IPSS　at　6　months,　12　months　and　24　months　was　10.12,　11.30　and　11.86,　respectively,　which　were　statistically　significant　compared　with　baseline　(P＜0.05).　Predictors　of　clinical　success　were　greater　prostate　volume　(＞　65　ml,　P　=　0.018),　adenomatous-dominant　benign　prostatic　hyperplasia　(AdBPH)(P　=　0.030),　indwelling　catheterization　due　to　urine　retention　(P　=　0.028),　and　bilateral　embolization　(P　=　0.018).　Conclusion:　PAE　was　able　to　significantly　improve　BPH-related　LUTS　and　the　outcome　indicators　remained　stable　at　long-term　follow-up.　Preoperative　urinary　retention　catheters,　AdBPH,　larger　prostate　volume　(＞　65 ml)　and　bilateral　embolization　suggest　better　clinical　efficacy.　©　The　Author(s),　under　exclusive　licence　to　Springer　Science+Business　Media,　LLC,　part　of　Springer　Nature　2024.