Objective: To evaluate the 3-year clinical outcomes and durability of photoselective vaporization of the prostate (PVP) with the GreenLight HPS laser in the treatment of symptomatic and obstructive benign prostatic hyperplasia (BPH). Methods: A total of 78 patients underwent PVP with the GreenLight HPS laser from October 2007 to November 2008. The baseline and treatment outcomes after surgery were evaluated 3 years later with the International Prostate Symptom Score (IPSS), quality of life (QoL), maximum flow rate (Qmax), postvoid residual rate (PVR), and transrectal ultrasound-determined prostate volume. These parameters were assessed at 1, 3, 6, 12, 24, and 36 months. Results: Patients’ urinary symptoms and QoL significantly improved after surgery. The functional outcomes showed immediate and stable improvements during the entire follow-up period. At 36 months, the average percentage of improvements compared with baseline was as follows: IPSS, 60.2%; QoL, 80.9%; Qmax, 138.7%, and PVR, 82.6%. The median prostate volume, evaluated by transrectal ultrasonography, showed a 50.4% reduction when compared to preoperative volume. Overall, complications from surgery were low; only 6.7% of the 75 patients required reoperation during the 3-year follow-up. Conclusion: PVP using the GreenLight HPS laser showed a safe and effective treatment outcome for the treatment of symptomatic and obstructive BPH.