Objective The severe hypospadias is present with complicated deformity,and the successful rate of treatment is low with high complication rate.Here is to present a kind of useful and reliable treatment for it.Methods From 2004 to 2005,the scrotal septal island skin flap combined with the scrotal split thickness skin graft to form the neourethra in a stage was used to treat the hypospadias without underdeveloped scrotum.Results A total of 15 patients including proximal penile,penioscrotum and scrotal hypospadias who were followed up for about 1 year healed well without the occurrence of urethral stricture and urethral fistula,the penile curvature was corrected and the urine line was direct,and the endoscopic examination showed the inner wall of the urethra was smooth and intact.Conclusions The application of the scrotum septum flap combined with the scrotal splitted thickness skin graft to form the neourethra in one stage is reliable to treat the severe hypospadias with the simple procedure.The combined technique has obtained both the advantages of the skin graft and the skin flap to form the neourethra,and it could be used to correct the curvature of the penile.Thus the satisfactory result of the appearance and the function could be achieved.The technique is an excellent procedure.