Hypospadias (Fig. 7.1) is one of the more common conditions treated by pediatric urologists. Its incidence is around 8–16/1,000 live births.1 The penis is fully developed within the first 12–16 weeks of embryonic life so there is no associated increased risk of having hypospadias in premature neonates. This entity is usually referred after recognizing the defect at birth. The examiner will note in 95% of the cases that boys with hypospadias will have an incomplete hooded foreskin that is mostly dorsally located and that the opening of the penis is somewhere beneath the normal orthotopic location at the tip of the glans. The opening can be anywhere from 1 mm below the glanular tip to the level of the perineum in the most severe cases. The majority of hypospadias defects are distal in about 70% of the cases.