Background: Longitudinal Dorsal Island Flap (LDIF) can be employed to overcome the drawbacks of onlay and tubularized urethroplasty in management of hypospadias. Objective: To improve outcome and reduce complications of cases with proximal hypospadias associated with severe chordee and deficient urethral plate by using longitudinal preputial double-layered island flap two stage technique. Patients and Methods: we included twenty patients, who had proximal hypospadias associated with deficient urethral plate, and were admitted to Pediatric Surgery Department at Zagazig University Hospital during study period. Results:The results of our study showed early complication after 1 st stage: wound infection only in one case (5%), which was complicated by fistula formation, which was closed spontaneously. After 2 nd stage the results showed 3 cases suffering from meatal stenosis managed by repeated dilatation but unfortunately one of them suffering from urethral diverticulum later on. Also, one of cases complicated with urethral fistula, which needed surgical repair. The cosmetic appearance was not good after the 1 st stage, but it became better after the 2 nd stage as the excessive tissue was removed and the meatus reached the position on glans penis. Conclusion: For proximal hypospadias repairs, the longitudinal preputial island flap approach has an excellent success rate and is suitable for a wide range of cases. It is considered as good option especially in patients with underdeveloped urethral plate among proximal hypospadias patients.