Background: Hypospadias is a prevalent congenital anomaly in male infants, occurring in approximately 1 in 300-400 live male births [1]. Distal penile hypospadias constitutes about 80% of cases [2]. The Snodgrass tabularised incised plate (TIP) repair and the Slit-Like Adjusted Mathieu (SLAM) repair are two widely accepted surgical techniques for distal hypospadias, each with unique approaches to meatal construction and cosmetic outcomes [3,4]. Methods: A prospective study(retrospective study)was conducted from January 2021 to December 2023(using data from Jan 2019 to June 2024)at Mahatma Gandhi Hospital (MGH), Jaipur. A total of 67 male patients diagnosed with primary distal hypospadias were enrolled and divided into two groups based on surgical technique: SLAM (Group I, n=31) and TIP (Group II, n=36). Patients were followed up for six months postoperatively. Standardized SLAM and TIP procedures were employed. Inclusion criteria included all male patients with primary distal hypospadias, while exclusion criteria comprised significant chordee (>30 degrees), previous hypospadias surgery, and glanular hypospadias. Results: The overall complication rates were comparable between the SLAM and TIP groups, with 16% (5/31) in SLAM and 16.7% (6/36) in TIP (p=0.95). Specifically, SLAM demonstrated a 0% incidence of meatal stenosis compared to 5.55% in TIP (p<0.05). However, flap necrosis/wound dehiscence was higher in SLAM (6.45%) than TIP (2.78%) (p=0.34). Cosmetic outcomes favored TIP, with 97.2% (35/36) achieving a vertical slit-like meatus versus 74.19% (23/31) in SLAM (p=0.003). Conversely, fish-mouth meatus was observed in 25.8% of SLAM patients compared to 2.77% in TIP (p=0.001). Figures 1 and 2 illustrate the cosmetic differences between the two techniques, while Tables 1-3 detail complication rates and cosmetic outcomes. Conclusion: Both SLAM and TIP techniques exhibit similar overall complication rates in the management of primary distal hypospadias. TIP offers superior cosmetic outcomes with a lower incidence of meatal stenosis, whereas SLAM is associated with a higher rate of flap necrosis. SLAM may be preferable in cases with a narrow or unhealthy urethral plate.