Objectives: Determine if men with type 2 diabetes who take a-blockers (ABs) for benign prostatic hypertrophy gain additional benefit with reduced diabetic complications. Methods: Chart review of 1,100 men with type 2 diabetes and benign prostatic hypertrophy taking either an angiotensin-converting enzyme inhibitor or angiotensinreceptor blocker. Results: Of the 1,100 men, 330 took ABs and 770 did not take ABs. Despite no difference in blood pressure between men taking or not taking ABs, those taking them had more evidence of renal and cardiovascular disease. The prevalence of complications varied among the AB types with tamsulosin users having more coronary artery disease diagnoses and doxazosin users having more renal disease diagnoses. Conclusions: ABs when prescribed for benign prostatic hypertrophy not only failed to give additional protection against developing diabetic complications but were associated with more cardiovascular and renal disease diagnoses. Prospective randomized controlled trials are necessary to determine if there is a causal relationship between ABs and adverse outcomes in patients with type 2 diabetes and benign prostatic hypertrophy already on an angiotensin converting enzyme inhibitor or angiotensin-receptor blocker.