Urethral stones in men are rare clinical entity and most of them migrate from the urinary bladder. Urethral stones are rarely formed primarily in the urethra and are usually associated with urethral strictures or diverticula. We report a 41-year-old man with giant prostatic urethral stone (5.9x3.2x2.8 cm) associated with a urethrocutaneous fistula. The etiological factors, pathogenesis, clinical presentation, complications and management of giant urethral calculi are reviewed.