We describe our experience with dermal grafting for the treatment of Peyronie's disease in 27 patients over a 3-year period. With the various nonsurgical treatments, a significant number of patients remain handicapped by the disease. For this unresponsive group, we recommend surgical excision of the penile plaque with dermal grafting. The proper selection of patients for this operation is of paramount importance, and this can be facilitated by a preoperative psychological evaluation in doubtful cases.