The preputial island flap technique presented here was described by Scuderi for a one-stage repair of hypospadias. The operation utilizes a subcutaneous pedunculated preputial flap, designed dorsally along the vertical axis of the penis and transposed ventrally to reconstruct the new urethra. This surgical procedure is useful in distal and proximal hypospadias or in cases with short or absent prepuce, when the dorsal coating of the penis can be used. The technique permits a complete release of the chordee and a meatus placed at the apex of the glans. One hundred and twenty-seven patients treated during the period 1982 to 1987 were analysed. All patients had a urodynamic check and some also had a urethroscopic evaluation of the new urethra. The incidence of complications (8.65%) was very low compared with other techniques.