Objective To investigate the efficacy and experience of oral mucosa (lower lip mucosa and tongue mucosa) and penile skin flap in repairing complex anterior urethral stricture. Methods The data of 33 patients with complex anterior urethral stricture caused by various reasons undergoing oral mucosa graft urethroplasty or penile skin flap urethroplasty in our hospital from Aug. 2012 to May 2018 were retrospectively analyzed. Oral mucosa graft urethroplasty was suitable to patients with insufficient prepuce, multiple urethral stricture, or a history of urethral surgery. Penile skin flap urethroplasty was suitable to patients with sufficient prepuce and without a history of urethral surgery. The preoperative information and postoperative follow-up data were collected, and the differences of maximum urinary flow rate and international index of erectile function 5 (ⅡEF-5) were compared and analyzed before and after operation. Results The 33 patients were 12-80 years old, with an average of (43.5±19.3) years old. Twenty-three patients underwent oral mucosa graft urethroplasty, and the length of the urethral stricture was 5.0 (3.0-12.0) cm. Ten patients underwent penile skin flap urethroplasty, and the length of the urethral stricture was 4.0 (3.0-7.0) cm. The postoperative follow-up period was 20 (12-36) months. Two patients in the oral mucosa graft urethroplasty group developed urethral stricture recurrence and 1 patient in the penile skin flap urethroplasty group developed urinary fistula during the follow-up. In the oral mucosa graft urethroplasty group, 21 patients voided well, and the maximum urinary flow rates were 5.0 (0.0-8.2) mL/s and 19.6 (12.2-21.7) mL/s before and 1 year after operation, respectively, showing significant difference (P<0.01); the ⅡEF-5 scores were 14.0 (5.0-18.0) and 16.0 (4.0-21.0) before and 1 year after operation, respectively, showing no significant difference (P>0.05). In the penile skin flap urethroplasty group, 9 patients voided well, and the maximum urinary flow rates were 6.1 (0.0-12.0) mL/s and 20.4 (13.6-23.6) mL/s before and 1 year after operation, respectively, showing significant difference (P<0.01); the ⅡEF-5 scores were 15.0 (7.0-19.0) and 17.5 (3.0-23.0) before and 1 year after the operation, respectively, showing no significant difference (P>0.05). Conclusion Oral mucosa and penile skin flap are promising substitutes for urethroplasty, and they can be selected for urethroplasty according to patient's physical condition.