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Abstract: Objective: There is growing interest in preputial reconstruction combined with hypospadias repair as an effective technique. We retrospectively analyzed our results and compared them with the literature for future patient information. Materials and methods: We evaluated 35 boys during 1 year who underwent distal hypospadias repair combined with preputial reconstruction to determine complications, risks and failures. Results: At a mean follow up of 1.2 years, 28 patients had an anatomically normal penis with a normal retractable foreskin, while seven (20%) had some sort of complication. There was a complication of the reconstructed foreskin only in three cases (8.25%), and with the reconstructed urethra in four (10.4%). The most common complications were fistulae of the prepuce and urethra. Only two needed re-operation; the others were managed conservatively. On follow up parents were generally satisfied with the results. Conclusions: Preputial repair combined with hypospadias repair lead to anatomically correct reconstruction of the penis at the cost of an 8.25% complication rate. Results were comparable with the standards seen in the literature. [Copyright &y& Elsevier]