We report the results of hypospadias repair in 60 children requiring urethral reconstruction using a longitudinal or oblique preputial island flap technique that includes the inner and outer surfaces of the prepuce to construct the neourethra. Mean patient age was 3.2 years and mean length of the repair was 3.1 cm. The cosmetic and functional results were satisfactory. The incidence of urethrocutaneous fistula was 8.3% and that of meatal stenosis was 5%. Thus, this modification offers good results with a low complication rate. The range of applications can be extended by combining the technique with a tube of midline scrotal skin in cases of scrotal or perineal hypospadias. The surgical technique is described in detail.