The presence of an accessory phallic urethra in the female patient is uncommon. Virilization is not a factor and local embryologic interactions seem capable of explaining the varied spectrum of lesions seen. Abnormal descent of the müllerian ducts results in posterior displacement of the vaginal introitus, allows the accessory phallic urethra to form and results in an unusually prominent phallus. Genitoplasty without ablation of the accessory urethra is recommended.