OBJECTIVE: To determine the long‐term outcome of endoscopic urethrotomy for primary urethral strictures based on a population‐based approach. *** PATIENTS AND METHODS: We analysed a nationwide database of all patients with urethral stricture disease who underwent endoscopic urethrotomy as a primary intervention between January 2006 and December 2007. All patients were followed individually for 7–9 years. Frequencies and types of surgical re‐interventions were documented. Repeat surgical interventions were stratified into three treatment types: urethrotomy, urethroplasty, and end‐to‐end urethral anastomosis. *** RESULTS: A total of 1203 men underwent urethrotomy during the index period. The median (SD, range) patient age was 63 (15.7, 20–85) years. A total of 136 patients (11%) died during follow‐up. Within the follow‐up period, 932 patients (78%) received no further surgical re‐intervention for recurrent disease, and 176 patients (14.6%) required one, 53 (4.5%) two, and 41 (3.4%) three or more procedures. The mean number of re‐interventions was 1.5/patient and the lowest re‐intervention rate was in patients aged ≥80 years (13.9%). In 236 cases (68%) at least one repeat urethrotomy was performed. An open reconstruction was performed in 87 cases (32%), with urethroplasty in 21 patients (24%), and end‐to‐end anastomosis in 66 patients (76%). The mean interval until re‐intervention was 29.5 months. *** CONCLUSIONS: This long‐term population‐based study suggests that the invasive re‐treatment rate in men following initial urethrotomy is 22% within 8 years and lowest in the advanced age cohort.