Urethral dilatation and urethrotomy can be effective treatments of the stricture disease in selected patients when the spongy tissue is not severely damaged. In the few reports comparing urethrotomy and dilatation, results are not significantly different. A long term followup is mandatory in assessing the outcome of treatment of urethral strictures. Characteristics of the stricture as location, length, caliber, number, and previous failed treatments allow to select the best therapeutical option. After the failure of the first instrumentation, repeated procedures are not curative.