Sixteen patients, between 2 and 45 years old, with hypospadias underwent repair with our new skin closure procedure called ipsilateral penoscrotal approximation for closure (IPSAC). Complete functional success was obtained in all 6 patients with distal hypospadias and in 7 of 10 patients with proximal hypospadias. Meatal regression and urethrocutaneous fistula were complications in one-stage repair. Another urethrocutaneous fistula resulted from fifth-stage repair in the case of an adult hypospadias cripple. Cosmetically, there were two cases with unsightly thickening of the base of the penis in this early series. It was found that this IPSAC procedure had two major advantages: it provided (1) a tension-relieving skin closure, and (2) correction of scrotal deformity, especially in one-stage repair with the parameatal flap and in multi-staged repair with absolute penile skin deficiency.