ABSTRACT Purpose We update our long-term data on the effectiveness of urethroplasty. Materials and Methods A total of 166 patients operated on before 1990 are currently under followup or lived at least 10 years after surgery. Anastomotic urethroplasty was performed in 82 patients and substitution urethroplasty in 84. Results The 5, 10 and 15-year re-stricture rates after anastomotic urethroplasty were 12%, 13% and 14%, respectively, and the complication rate was 7%. The 5, 10 and 15-year re-stricture rates after substitution urethroplasty were 21%, 31% and 58%, respectively, and the complication rate was 33%. Conclusions The results of anastomotic urethroplasty are good and sustained in the long term, while the results of substitution urethroplasty deteriorate steadily with time and there is definite room for improvement. An anastomotic repair should be performed in preference to a substitution repair when possible.