Complex post traumatic posterior urethral strictures in children constitute a major challenge to the pediatric urologist. Surgical repair depends primarily on the length of the stricture segment. Resection with end to end anastomosis is the main procedure in the face of a short segment stricture. Transpubic urethroplasty and substitution urethroplasty are in current use in the face of extensive and complex urethral strictures.50 boys with a mean age of 9 years (6-13) with different forms of posterior urethral strictures were operated on in the period from May 1999 to August 2006. Short posterior urethral strictures were treated by excision and end to end anastomotic urethroplasty in 40 boys. Long posterior urethral strictures were managed by combined inferior pubectomy in 3, transpubic urethroplasty in 4 and tubed penile fascio-cutanous flap in 3.There was a mean follow up of 4.5 years (6 months-7 years). All children that underwent a perineal anastomotic urethroplasty had a successful repair with no complications. A transpubic urethroplasty was associated with a restricture in one child 6 years following the repair. In the group repaired by a tubed fascio-cutanous flap, we encountered a distal anastomotic stricture accompanied by a proximal huge diverticulum which needed revision in one child and another diverticulum with multiple stones in another one who was treated successfully.Urethroplasty in children is feasible with good results. Proper evaluation is needed to choose the best surgical technique for each patient. Tubed fascio-cutanous flap carries the highest complication rate.