Yong Wei,* Yu-Peng Wu,* Ning Xu,* Xiao-Dong Li, Shao-Hao Chen, Hai Cai, Qing-Shui Zheng, Xue-Yi Xue Department of Urology, First Affiliated Hospital of Fujian Medical University, Fuzhou, China *These authors contributed equally to this work Purpose: To analyze the Surveillance, Epidemiology, and End Results (SEER) database to determine the effects of sex and prognostic factors on the survival of patients with primary urethral carcinoma (PUC). Materials and methods: We selected 453 patients diagnosed with PUC from 2004 to 2013 from the SEER database. Statistical analysis was used to identify sex-specific differences associated with tumor characteristics and cancer-specific survival (CSS) and overall survival (OS). Results: Compared with men, there was a higher proportion of black women, more negative lymph-node status, higher American Joint Committee on Cancer (AJCC) stage, more advanced T3 stage, more with adenocarcinoma (Ac), and fewer with squamous cell carcinoma (SCC) or transitional cell carcinoma (TCC). Among women, black race and M1 stage were associated with shorter CSS and OS, respectively. In addition, surgery was associated with longer OS in women. Among men, AJCC III and IV and M1 stages were associated with shorter CSS and OS. In addition, age >75 years associated with shorter OS in men. Conclusion: Black race was associated with shorter OS and CSS of women, and surgery was associated with longer OS of women. Among men, AJCC stage III and IV were associated with shorter OS and CSS. Age >75 years was associated with shorter OS in men only. Women with Ac experienced poor CSS compared with men. Men with TCC experienced worse CSS compared with those with Ac or SCC. Keywords: sex, prognostic, survival, transitional cell carcinoma, adenocarcinoma, squamous cell carcinoma