Urethral catheterization is one of the most fundamental routine clinical procedures. Males are more prone to difficult catheterization due to the anatomical characteristics of the urethra. Blind manipulation may cause iatrogenic urethral injury and long-term urethral stricture, yet unified domestic standards are currently absent in China. Based on the GRADE evidence grading system, combined with domestic and international evidence-based medical data and the actual clinical practice in China, the consensus on the management of difficult male urethral catheterization has been formulated. This consensus clarifies the standardized definition and three-tier clinical grading criteria for difficult male urethral catheterization, and systematically sorts out risk factors including benign prostatic hyperplasia, urethral stricture, pelvic trauma and iatrogenic manipulation. It standardizes preoperative assessment and tiered procedural workflows, and recommends a stepwise management algorithm consisting of conventional catheterization, coude catheterization, guidewire-assisted catheterization, endoscopic-guided catheterization, and suprapubic puncture cystostomy. Strategies for the prevention and treatment of complications such as hemorrhage, false passage, infection and secondary urethral stricture are elaborated in detail, and tiered training for medical staff, procedural quality control and consultation protocols are also proposed. The consensus emphasizes that non-urological practitioners shall promptly refer patients to specialized urologists when encountering high-risk scenarios such as catheter resistance or hematuria, to avoid repeated forceful catheterization. This consensus provides unified, actionable guidance for medical staff at all levels of medical institutions to manage difficult male urethral catheterization, standardizes clinical workflows, and lowers the risk of urethral injury caused by inappropriate catheterization operations.