We review the literature and report a series of eight cases of balanitis xerotica obliterans (BXO) developing in patients following primary hypospadias repair. The ages of these patients ranged from 8 to 25 years with BXO developing from 1 to 16 years postoperatively. Six patients were treated by excision of the BXO tissue and two-stage urethroplasties with full-thickness grafts. Three of these patients had further recurrence of BXO and had re-do urethroplasty using a combination of bladder and buccal mucosa. The last two patients in this series had re-do urethroplasty using bladder mucosa only and bladder-buccal mucosa technique, respectively, as first choice for BXO complicating their hypospadias repair.