A buccal mucosa graft from the lower lip was used for meatal reconstruction in 3 patients. The buccal mucosa graft was combined with a bladder mucosa graft for urethral substitution in 1 adult and 1 child, and was anastomosed to a skin tube for creating a glanular urethra in 1 child. The buccal mucosa graft obtained was approximately twice as wide as the desired urethra. Postoperatively the buccal mucosa graft became shrunken at the proximal anastomosis and urethral stricture developed in 2 children. The graft did not shrink at the meatus, but the meatus became widened in 2 patients. These results suggest that a buccal mucosa graft is useful for meatal reconstruction, but further technical improvement is necessary to avoid postoperative complications.