Hypospadias repairs historically presumed that urethral plate division was required to straighten the penis. We now understand chordee to be a result of skin asymmetry and subcutaneous tissue and that the urethral plate is a vascularized tissue bed that can be incorporated into a repair. We descrip the onlay island flap procedure that has enabled over 90% of our repairs to be completed in 1 stage without division of the urethral plate.