Objectives: Medication noncompliance is a recognized problem worldwide. This study evaluated the factors associated with compliance, discontinuation and switching of finasteride among Chinese benign prostatic hyperplasia patients. Materials and Methods: A retrospective cohort study was conducted with 682 outpatients newly diagnosed with benign prostatic hyperplasia and prescribed with finasteride from January 2008 to December 2009, taken from a database. We evaluated their compliance by medication possession ratios, discontinuation and switching rate after the prescription for an average observation period of 15 months. Multiple association factors were identified and evaluated using multivariate logistic regression analyses. Results: The crude compliance level, discontinuation and switching rates were 29.3, 60.6 and 10.1%, respectively. Older age (≧60 years), combination therapy, medical insurance and chronic comorbidities were positively associated with good compliance. Younger age was significantly associated with drug discontinuation or switching. Those patients on finasteride monotherapy and without medical insurance were significantly associated with discontinuation of drugs. Conclusions: Patients <60 years of age, on monotherapy and without medical insurance were less likely to be compliant with their newly initiated finasteride treatment. Consequently, more efforts should be made among this group to increase treatment adherence.