When penile cancer recurs, excision is often the only feasible option. However, the reporter recently learned from the Third Hospital of Sun Yat-sen University that the hospital adopted the method of removing tumor tissues while performing frozen section for a patient with recurrence, which preserved the “vital root” not invaded by tumor to the maximum extent and enabled the patient to stand and urinate like a normal male. The patient, a native of Guangdong, had undergone partial penectomy in his hometown for “penile squamous carcinoma”, but within 2 months of the surgery, the lesion recurred and continued to expand. After being transferred to Zhongshan Hospital, he was confirmed to have a medium-differentiated squamous carcinoma, but fortunately no metastasis had occurred. After the specialist consultation, it was considered that the patient’s recurrence after surgery and the fact that part of the penis had been removed and the lesion was obviously infiltrated with high malignancy, further preservation of the penis seemed impossible and total penile excision was considered to be the best option and the urethra needed to be reset. However, when the patient heard that he had to squat and urinate like a woman after total penile excision, he was very discouraged and lost hope for life. Considering the patient’s pain, the specialists consulted and discussed again and confirmed the use of Mohs microscopic tracing surgical method commonly used in dermatology, which means real-time frozen section monitoring of the excised tumor tissue intraoperatively to preserve the penis not invaded by the tumor. The surgery was successful, not only the tumor was pathologically confirmed to be cleanly removed, but also a long enough penis was preserved for the patient to urinate like a normal man, restoring his male dignity. It is reported that this technique is widely used in the treatment of skin malignancies, and is not commonly applied to penile cancer excision.