For the general public, hypospadias is an unfamiliar disease for two main reasons. One, hypospadias is not as common as colds and diarrhea; and two, because it occurs in the genitals and is influenced by the traditional national concept of privacy, it is not advisable to spread or publicize the disease. In fact, hypospadias is a common genital malformation in young boys, with about 30,000 new cases in China every year. It is also a disease that pediatric urologists often face. The reason for its prevalence is related to genetics, intrauterine factors (including environmental pollution, the so-called environmental hormones), etc. The children with hypospadias admitted to our department are not only from Shenzhen and surrounding areas, but also from Sichuan, Jiangxi, Hunan, Hubei, Guizhou, Hainan and other places. Hypospadias is not a cracked or split urethra, but a developmental disorder of the urethra during the embryonic period, resulting in a section of the urethra not growing out, and what is seen after birth is an abnormal urethral opening. It is possible that the urethral defect is only in the section of the glans, which is only a few millimeters away, or the defect may be from the glans to the body of the penis or even further, when it is several centimeters away. Clinically, it is often classified by appearance as glans, coronal, penile body, penile-scrotal junction, perineum, etc. Some also classify it as light, medium or heavy (light is not meant to be well treated) for the sake of description. Not only that, hypospadias is often accompanied by a downward bending deformity of the penis, even in the shape of a hook, and there is no foreskin tie, and the distribution of the foreskin is also abnormal (more dorsal than ventral) and covers the glans in a turban-like manner. There are also cases where the scrotum of the penis is transposed (i.e. the scrotum surrounds the penis) and the scrotum splits into left and right halves. Therefore, hypospadias is one of the most serious malformations of the development of the penis and urethra. Hypospadias does not grow back on its own, as parents expect, but must be treated surgically. Through clever design and surgical methods, specialists straighten the curved penis and make the defective urethra, while making the shape as close to normal as possible, so as to meet the functional requirements of the child’s standing position for urination and future sexual life. The most difficult part of the procedure is to make a skin tube to replace the urethra. The surgeon will use the child’s own materials, such as the urethral plate, foreskin, scrotal skin, and even oral mucosa. The skin tube made of these materials may develop a fistula or urethral stricture during the healing process, or it may become dilated or form a diverticulum long after the procedure because the skin tube is not able to resist the pressure of the urinary flow like a normal urethra. If a fistula, urethral stricture, or urethral diverticulum develops, it will require reoperation. To date, the treatment of hypospadias is still quite difficult in the field of medicine both at home and abroad and requires experienced specialist treatment, with some patients requiring two or more operations to achieve the final goal. There is also a very small number of sick children who, due to their constitution (e.g. scarring) and other reasons, may form a defect that is difficult to correct and is medically known as hypospadias mutilans. It is worth telling parents that hypospadias surgery is very complicated and the international concept and methods of hypospadias treatment are constantly advancing. In the past, emphasis was placed on the success rate of a single operation, but now more emphasis is placed on the post-operative urinary function and the long-term penile morphology and the satisfaction of sexual life in adulthood. There are two types of surgical plans: one-stage and staged options. Staged surgery is a planned procedure to straighten the penis during the first stage of surgery; the second stage is followed by a skin tube instead of a urethra to achieve an opening for urination from the glans. Some studies have shown that some children who take the second-stage surgery option have better final results than the first-stage surgery option. Therefore, it is recommended that parents do not demand too much success from a single surgery, but rather leave it up to the surgeon to make the most appropriate decision. The goal is to have the best end result, not the least number of surgeries as the first consideration. There is no particular age limit as to when hypospadias should be treated, and surgery is most often performed between the ages of 2 and 3. With advances in technology and improvements in anesthesia and care, the age of surgery now tends to be earlier. Parents should also be reminded that hypospadias needs to be followed up and observed for several years after surgery, especially in the first 1-2 years after surgery to allow for timely detection and management of complications. In conclusion, although hypospadias is a serious deformity and a disease with a troublesome treatment process, it is a treatable disease and parental cooperation is an important factor in obtaining good results.