The external meatus anomalies should be diagnosed prior to the MAGPI in coronal hypospadias, but should also be looked for if a flap technique is considered in distal penile cases. The incidence of hypoplasia in the perimeatal area has been found to be 19% and 12% in coronal and distal penile hypospadias, respectively. Hypoplastic meatus prevents safe elevation of the skin flap, and needs its incision or wedge excision before the flap has been outlined.