Background: The megameatus intact prepuce (MIP) variant of hypospadias is a rare variant of hypospadias that is diagnosed either early at the time of circumcision or later as the foreskin is retracted. The true incidence of the anomaly is difficult to determine precisely as some patient never come to medical attention but is felt to under 5% of all cases of hypospadias. Objectives: To assess the outcome of Inframeatal vascularized flap in surgical correction of MIP regarding as Functional outcome (Adequate forward stream). , Cosmetic. , Complication. Methods: This prospective study included 12 patients with Megameatus Intact Prepuce Variant of Hypospadias presented to Zagazig university hospitals scheduled for surgical repair by Mathieu Technique. Result: Two patients with early complication; one patient complicated with infection and edema other patient's complicated infection only. Two patients with late complications: there were 2 cases fistula treated surgically by fistula closure after 6 months and there was no dehiscence and no meatal stenosis. According to our definition of success: Success rate 10/12 = 83.3%. Conclusion: Inframeatal vascularized flap urethroplasty may offer better outcome regarding urinary function and cosmesis with low complication rate, however larger number of cases with longer follow up period are needed for better evaluation of such technique.