Hair tourniquet syndrome is characterised by circumferential strangulation of an appendage or genitalia by human hair or fibres. Here we are reporting a rare case of distal penile urethrocutaneous fistula and its management due to penile hair tourniquet in a 16 year old child. High index of suspicion is needed to identify the condition. Early diagnosis and appropriate treatment can prevent the loss of glans and other complications. Child abuse should be considered carefully in suspected cases.