Background: Posterior urethral strictures remain an everyday challenge in urological practice. Different types of operations to repair the stricture have different outcome concerning re-establishment of the urethral function and anatomy. Posterior urethroplasty is one of the frequently chosen operations. The aim of this study is to reveal indications, results and complications of posterior urethroplasty performed on fifteen patients with long posterior urethral strictures in a major urological center.Methods: Fifteen male patients have undergone anastomotic perineal urethroplasty for long posterior urethral strictures in the period from September 2010 to August 2016. The patients age ranged between 12-42 years (mean =28). They were referred to Al-Karama urological center from emergency hospitals, and Al-Hussain teaching hospital came to medical consultation to the center with established strictures. They were evaluated thoroughly pre-operatively with cystogram and retrograde urethrogram (RUGs).Results: Success rate was 66.7%. The follow-up period was short, no patient needed re-operation. Most had normal caliber urinary stream and required no optical urethroplasty or dilation. Failure noticed in two patients, one of them developed impotence post-operatively.Conclusions: The study concludes that open perineal urethroplasty remains the gold standard for the management of long posterior urethral strictures.