From 1970 to 1981 urethroplasty was done in 79 patients and internal urethrotomy under vision was done on 166 urethral strictures from 1977 to 1981. We feel that urethroplasty and internal urethrotomy complete each other. Both of them are successful in some 85% of cases. Direct vision cold knife internal urethrotomy increases the scope of our surgical possibilities in urethral strictures. It should normally be the first treatment. Internal urethrotomy can be performed in all types of urethral strictures. The patients are not severely affected. The advantage of this method is that it can be used at an old age, too. In acute urinary retention as a consequence of urethral stricture internal urethrotomy can also be utilized. It can be done in a second or third procedure. If urethroplasty must be done after internal urethrotomy all surgical possibilities remain. We prefer urethroplasty for long strictures, especially in the membranous urethra, and multiple strictures.