The surgical therapy of the urethral strictures is still controversial as it interests the choice of an appropriate technique among many methods. In cases of complex urethral strictures, urethroplasties using genital or extragenital tissue for reconstruction are indicated. Scrotal in-lay was popular some years ago, but the complications rate was high. Nowdays, the two techniques with better outcome are the mesh graft urethroplasty and the buccal mucosa on-lay urethroplasty.