Voiding difficulties in women are common but are often overlooked. The diagnosis of bladder outlet obstruction is difficult to establish due to a lack of consensus on diagnostic criteria. Published studies suggest that a-blockers, both a1 and a1 A selective, alleviate voiding symptoms in women with functional bladder outlet obstruction and achieve improvements in objective outcomes such as detrusor pressure, urine flow and postvoid residual urine. Tolerability of treatment was good. Nevertheless, recommendations are impossible to make as existing trials have used different diagnostic criteria, treatment regimens and outcomes. High-quality, randomized controlled trials are needed to clearly establish the efficacy and safety of using a-blockers in female populations with bladder outlet obstruction.