Abstract Purpose We describe endoscopic findings and treatment outcome in 17 men who presented with a symptomatic anastomotic stricture after radical prostatectomy. Materials and Methods Endoscopic evaluation revealed an immature stricture in 6 men, which was treated by initial dilation and subsequent cold-knife urethrotomy. The 11 men with a mature anastomic stricture were treated by initial cold-knife urethrotomy (10) or dilation followed by urethrotomy (1). Results There were no long-term complications from treatment, which was successful in 15 of the 17 men (88 percent). Conclusions Initial dilation with subsequent urethrotomy for immature or initial urethrotomy for mature anastomotic strictures is a safe and effective treatment plan.