Objective To investigate the effect of penile-scrotal junction incision combined with penile lengthening (Devine surgery) in the treatment of moderate to severe pediatric concealed penis. Methods A total of 70 children with moderate to severe concealed penis who were treated in the Second Affiliated Hospital of Xi'an Jiaotong University from November 2020 to November 2023 were randomly divided into routine group and study group, with 35 children in each group. The routine group was treated with penile-scrotal junction incision, and the study group was treated with penile-scrotal junction incision combined with Devine surgery. The clinical efficacy, complications and non-erectile penis length were compared between the two groups. Results The total effective rate of treatment in the study group was 94.29%, which was higher than 77.14% in the routine group (P <0.05). The incidence of complications in the study group was 2.86%, which was lower than 17.14% in the routine group (P <0.05). After treatment, the length of non-erectile penis in the study group was longer than that in the routine group (P <0.05). Conclusion Penile-scrotal junction incision combined with Devine surgery is effective in the treatment of moderate to severe concealed penis in children, which can improve the total effective rate of treatment and prolong the length of non-erectile penis. Meanwhile, the incidence of postoperative complications is small and the safety is high. It is worthy of clinical application.