This chapter provides a comprehensive overview of penile girth enhancement (PGE), tracing its evolution from historical experimental methods to modern surgical and nonsurgical techniques. Early attempts using paraffin, silicone, and other non-biocompatible substances were associated with severe complications. Subsequent advances, including dermofat grafting, autologous fat transfer, and biologic grafts, gradually improved safety and outcomes. Today, hyaluronic acid (HA) fillers represent a paradigm shift, offering a minimally invasive and patient-friendly approach. This chapter integrates historical context with technical details, clinical outcomes, and complication management to guide practitioners in the evolving landscape of PGE.