Fistula is the commonest complication after hypospadias surgery ranged 10-30%. The results of surgery depending on the severity of hypospadias, surgical technique, and experience of the operating surgeon. This is a prospective study analysis the operational procedures in post-hypospadias urethral fistula repair. Through July 2015 to January 2017, 21 patients with 21 fistulas where classified their treatment into: 6 fistula with simple closure, 7 fistula simple closure with fascial layer, and 7 fistula dorsal slit with fascial layer. According to my experience I have successfully treated all urethral fistulas using my method, with success rate. We concluded that the midline urethral incision with the dartos flip flap is the main point for treatment of difficult urethral fistula after hypospadias operation.