Urethral stricture may be caused by inflammation or scar tissue from surgery, disease, or injury. It may also be caused by external pressure from an enlarging tumor near the urethra, although this is rare.

Increased risk is associated with men who have a history of sexually transmitted disease (STD), repeated episodes of urethritis, or benign prostatic hyperplasia (BPH). There is also increased risk of urethral stricture after an injury or trauma to the pelvic region. Any instrumentation entering the urethra (such as catheterization or cystoscopy) increases the chance of developing urethral strictures.

Congenital (present at birth) pediatric strictures are rare, as are true strictures in women.