Background: Clear cell carcinoma (CCC) of the urethra is a very rare histologic variant of urethral adenocarcinoma. The majority of studies have been case reports and case series with no large population based studies. A retrospective analysis was performed with the National Cancer Institute’s (NCI) Surveillance, Epidemiology, and End Results (SEER) database to establish the epidemiology of urethral CCC and determine the clinical factors associated with survival. Methods: All cases of clear cell carcinoma of the urethra diagnosed from January 1, 1973 to December 31, 2014 were extracted from SEER. Age at diagnosis, sex, marital status, race, grade, stage, surgery, radiation, chemotherapy, overall survival (OS), disease specific survival (DSS), and survival months were extracted for analysis. Descriptive statistics were calculated for all variables. Univariable analysis to assess for differences in survival with respect to covariates was performed using the log rank test. Multivariable analysis was performed with Cox proportional hazards regression models to determine the predictive performance of covariates with respect to OS and DSS, reported as hazard ratio [HR] with 95% CIs. Comparisons were considered statistically significant at P < 0.05. Results: Sixty one cases were extracted for analysis. The mean ± SD was 63.0 ± 13.9 years. Fifty eight (95.1%) patients were female with 53 (86.8%) locoregional cases at presentation. There were 50 (82%), 18 (29.5%), and 12 (23.0%) patients who underwent surgery, radiation, and chemotherapy, respectively. On univariable analysis, the following covariates were associated with both OS and DSS: age, stage, and surgery (all p < 0.001; log rank test). On multivariable analysis, surgery was a predictor for improved OS and DSS (HR, 0.178; 95% CI [0.068; 0.464]) and HR, 0.166; 95% CI [0.196; 2.132], respectively). Additionally, both increasing age and distant disease were associated with worse OS and DSS. Neither radiation nor chemotherapy were significantly associated with OS or DSS. Conclusions: Surgery improves OS and DSS in patients with urethral CCC. While neither radiation nor chemo were significantly associated with survival, additional studies are necessary to determine how these therapeutic interventions may impact prognosis.