Objective To compare the treatment effect between Duply combined with Duckett and Koyanagi surgical methods in severe hypospadias.Methods Forty-two cases of severe hypospadias were divided into two groups according to the surgical method,23 cases was enrolled in Duply combined with Duckett group while 19 cases in Koyanagi group.The operation time,the incidence rate of urinary fistula,urethral stricture,urethral diverticulum and penis torsion were compared.Results The operation time between two groups had no significant difference (P ＞ 0.05).The incidence rate of urinary fistula,urethral stricture,urethral diverticulum and penis torsion between two groups had no significant difference (x2 =0.04,0.31,0.03,1.16,P ＞ 0.05).The total incidence rate of complications between Duply combined with Duckett group and Koyanagi group had significant difference [69.6％ (16/23) vs.6/19] (x2 =4.59,P ＜ 0.05).Conclusion Each of the two methods can be a choice in treatment of severe hypospadias.