Yu X, Nassar N, Mastroiacovo P, et al. - Live births, stillbirths, and elective terminations of pregnancy diagnosed with hypospadias during 1980–2010 from 27 surveillance programs worldwide were involved in order to investigate the prevalence and trends of hypospadias for these programs over a 31-yr period. For all years, the international total prevalence of hypospadias was 20.9 per 10,000 births. The prevalence of each program varied from 2.1 to 39.1 per 10,000 births. The international total prevalence rose 1.6 times during the study period, by 0.25 cases per 10,000 births per year. When investigated individually, during the early 1990s to mid-2000s, there were rising trends for first-, second-, and third-degree hypospadias. The majority of programs had a significantly rising trend during many of the years assessed. Although there have been variations in clinical practice and registry ascertainment over time in some countries, the persistence in the perceived rising trends across many programs and by degrees of severity implies that the total prevalence of hypospadias may be rising in many countries. This observation is contradictory to some former reports that implied that the total prevalence of hypospadias was no longer rising in recent decades.