Aim: The purpose of the present study was to evaluate and compare the 2 surgical approaches of urethral reconstruction for management of refractory female urethral strictures (FUS). Methods: The present study was performed in the Department of urology, Rajendra Institute of medical sciences (RIMS), Ranchi, Jharkhand, India for the period of 1 year to evaluate both surgical approaches and make a direct comparison between the two with total of 20 patients. The study was approved by the institutional ethics committee and written informed consent was obtained from all patients and provided guarantees of confidentiality. Results: The average age of patients in our study was 45 years (range 27-68). The demographic data of both the study groups was comparable. All patients presented with severe LUT symptoms with average AUA symptom severity score in patients preoperatively being 26. Eighty percent (16 out of 20) of patients had a history of undergoing multiple dilatations in the past, resulting in only temporary symptomatic relief. On preoperative uroflowmetry all patients had an obstructive flow with average Qmax of 7.0 mL/s (1.4-14 mL/s) and an average post void residual volume of 101 mL (range: 0-350 mL). Conclusion: Both dorsal and ventral approaches appear efficacious and provided good results. With further research into this domain, new insights will widen the repertoire and knowledge of reconstructive surgeons to provide the best treatment strategy for this condition. Dorsal approach appears more favorable in cases of stricture involving the distal most parts of the urethra.