Background:Serenoa repens extract is the phytotherapeutic agent most frequently used for the treatment of the urological symptoms caused by benign prostatic hyperplasia. There are many extracts in the market and each manufacturer uses different extraction processes; for this reason, it’s possible that one product is not equivalent to another. The aim of this study was to compare the activity of different extracts of Serenoa repens marketed in Italy. Methods: The following extracts were tested on 10 day co-cultured epithelial and fibroblast cells by a 5α-reductase activity assay: Permixon®, Saba®, Serpens®, Idiprost®, Prostamev®, Profluss® and Prostil®. In order to assess the variability in Serenoa repens products, 2 different batches for each brand were evaluated. Results and Conclusions: All extracts tested, albeit variably, are able to inhibit both isoforms of 5α-reductase. However, the potency of the extracts appears to be very different, as well as the potencies of 2 different batches of the same extract. This is probably due to qualitative and quantitative differences in the active ingredients. So, the product of each company must be tested to evaluate the clinical efficacy and bioactivity.