Hypospadias, a common congenital anomaly in newborns, accounts for a small proportion compared to major urological conditions, such as stones, prostatic hyperplasia, and urological tumors. However, this seemingly small disease causes a great deal of trouble for patients. In the past, hypospadias was not well known, probably because of poor economic conditions, low medical level and lack of publicity. In recent years, rapid economic development and the rapid spread of the Internet have made medical knowledge widely available, and young parents can easily find information about hypospadias on the Internet. Nevertheless, this miscellaneous specialized knowledge can still be confusing for non-medical readers. Therefore, here we will talk about hypospadias in a cursory manner in order to make more people aware of this congenital condition. First of all, what is hypospadias? As the name implies, hypospadias is an ectopic opening of the urethra on the ventral side of the penis, which is associated with hypospadias. The incidence of this disease is about 3-8 per 1,000 in foreign countries, while domestic data in 1997 showed that it was less than 1 per 1,000, but the incidence has been increasing year by year in recent years. There are three main clinical manifestations of hypospadias: 1) abnormal urethral opening; 2) abnormal foreskin distribution; 3) often accompanied by penile curvature. In addition, some patients often have a combination of cryptorchidism, penile scrotal transposition, gonadal dysplasia, etc. Since the features of hypospadias are very obvious, a simple physical examination of the patient after birth can detect the abnormality. However, in some economically underdeveloped and remote areas of China, some patients are still raised as girls at birth and the abnormality is not detected until the penis starts to develop during puberty. Patients with hypospadias usually have no obvious symptoms, except for some severe cases that require squatting to urinate like women, which may affect their sexual intercourse and fertility in adulthood. In addition to the physical effects, hypospadias can also cause psychological damage to the patient. Patients who find out that their genitals are different from those of normal people when they understand, often have low self-esteem, which may affect their integration into society. There are many causes of hypospadias, such as environmental pollution, hormone misuse, genetic mutations, etc. As of now, preventing hypospadias is still a difficult task. Therefore, our focus is mainly on the treatment of hypospadias, and surgery is the only way to treat it. The goal of surgery is not only to rebuild a complete urethra, but also to rebuild the patient’s self-confidence and help him/her to better integrate into society. According to incomplete statistics, there are more than 300 surgical procedures for hypospadias, with about 10 commonly used procedures. It is worth noting that there is no absolute best procedure for hypospadias, and experienced surgeons will choose the most suitable procedure according to the patient’s characteristics. The success or failure of the operation is not only related to the choice of the procedure, but also involves the choice of the timing of the operation. Foreign countries generally recommend surgery around 6 to 18 months of age, which can effectively balance the relationship between surgical results and psychological trauma. In China, it is generally considered that surgery can be performed around 1 year old, but it must be done before the patient understands. Considering the differences in penile development between the East and West, the development of the penis is necessary to determine the timing of surgery, and age can be used as an important reference item for a comprehensive assessment. Many patients and parents are resistant to staged surgery because they want to complete the surgery in one go. For patients, staged surgery prolongs the treatment time and increases the cost of treatment, while the risk is not significantly reduced compared to phase I surgery. This is actually a misconception. The current staged surgery is completely different from the earlier one: a hairless, smooth, flat urethral plate is reconstructed in stage I, and then the newly constructed urethral plate is used for coiling in stage II. This staged approach ensures a good penile shape with a successful outcome and is ideal for patients with severe penile curvature who need to disconnect the urethral plate for penile straightening, or who have experienced multiple failed surgeries for lack of penile skin. Does the fact that a patient has undergone a successful surgery mean that there will never be a problem again? No! Long-term complications of hypospadias, such as urethral stricture, re-curvature of the penis, and receding external urethral opening, need to be carefully monitored during follow-up visits to identify and treat them as early as possible. Some studies have shown that almost all patients develop some complications to a greater or lesser extent after 10 years. Therefore, patients with hypospadias still need to be followed up regularly after surgery. Although the urethra is a small and insignificant organ, its absence can cause a host of major problems, even the inability to reproduce. The good news is that hypospadias is now receiving more and more attention and it is believed that in the near future the treatment of hypospadias will become easier and the success rate will become higher.