Benign prostatic hyperplasia (BPH) is a prevalent condition in middle-aged and elderly men, often leading to lower urinary tract symptoms. Although traditional surgical interventions are effective, their limitations include high invasivity and prolonged recovery periods. In recent years, ultrasound-guided transperineal prostate thermal ablation has emerged as a minimally invasive alternative, gaining prominence due to its enhanced precision and low complication rates. This review examines the clinical advancements of three transperineal thermal ablation techniques: transperineal laser ablation (TPLA), transperineal radiofrequency ablation (TPRFA), and transperineal microwave ablation (TPMA). By analyzing recent clinical studies and trials, the procedural methodologies of each technique are elaborated, along with their respective clinical outcomes and associated complications. Furthermore, this work consolidates existing evidence to underscore the role of transperineal thermal ablation in personalized BPH management. This review aims to inform clinical decision-making and expand minimally invasive therapeutic options for BPH treatment.