© 2020 Blackwell Verlag GmbHBenign prostatic enlargement (BPE) is a disease that testosterone plays a role in its aetiology. Second to fourth finger ratio is a marker of prenatal androgenic exposure and may be a risk factor for several androgen-related diseases such as BPE. In this study, we investigated the relationship between the second to fourth finger ratio and BPE. A total of 63 patients with BPE were included for study group, and age-matched 63 healthy patients were included as a control group. Finger was measured by the distance from the proximal crease to the tip by using a digital caliper. The mean age of patients with BPE and non-BPE was 62 ± 8.9 and 61.5 ± 7.1 years respectively. There was statistically significant difference between groups in terms of prostate-specific antigen levels, prostate volumes and international prostate symptom scores. The mean finger ratios for right and left hand were 0.97 ± 0.03, 0.99 ± 0.03(p =.001) and 0.93 ± 0.15, 0.98 ± 0.03(p <.001) for BPE and non-BPE groups respectively. Men with a lower second to fourth finger ratio have higher risk of developing BPE than men without BPE. Therefore, the second to fourth finger ratio, which is indicative of prenatal androgen exposure, can be used as a marker of BPE risk.