The armamentarium of the reconstructive urethral surgeon is continuously evolving and requires the surgeon to be familiar with new concepts and concerns. The great elasticity and handiness of the buccal mucosa may increase the number of new surgical techniques that arrange the graft in original ways. The dorsal approach to the urethral lumen allows a variety of surgical options that vary according to the stricture site and characteristics or to the surgeon's preference. Long-term follow-up will be necessary to establish whether buccal mucosa is superior to penile skin as a urethral substitute and, in the future, it is possible that other materials will be available. The dorsal onlay techniques are simple, reliable, and effective over the long term; reproducible in the hands of any surgeon; and do not require extensive training in reconstructive procedures using tissue transfer techniques.