Penile augmentation strategies provide fascinating examples of humanity’s creativity and ingenuity in medical science. This essay summarizes the lengthy history of penile enhancement. Snake bites, herbal remedies, and traction therapy are examples of ancient penile enlargement strategies. Currently, injectable fillers and grafting represent modern techniques for girth enhancement. Meanwhile, V-Y advancement and suspensory ligamentolysis are foundational techniques for penile lengthening, along with penile disassembly, circumcision ligamentolysis, and sliding elongation. While these strategies can significantly increase penile length or girth, complications remain a concern, as do inconsistent psychological outcomes and patient satisfaction, even after measurable gains in penis size.