OBJECTIVES: To assess the safety and efficacy of a suprapubic prostatectomy technique performed in a rural hospital in Asia. METHODS: A retrospective study of 200 consecutive suprapubic transvesical prostatectomies with a removable bladder neck partition suture for benign prostatic hyperplasia from 1995 to 1998 in a rural mission hospital in northern Pakistan was performed. RESULTS: Despite preoperative comorbidities in 28% of patients, the postoperative morbidity (14%) and mortality (1%) was low. The partition suture is credited with a very low transfusion rate (1%) and a lower intensity of nursing care in the postoperative period. Patient satisfaction was high with regard to both relief of symptoms and cost. CONCLUSIONS: This study demonstrated that suprapubic prostatectomy with a routine bladder neck partition suture for benign prostatic hyperplasia can be carried out with a high degree of safety and efficacy in a rural setting with limited facilities in a developing country.