Constipation is very common in children and can be characterized by decreased frequency of bowel movements (≤2 times/week); dry, hard stools; difficult (laborious, time-consuming) bowel movements; painful bowel movements; and a sense of incomplete bowel movements. The prevalence of constipation in children is reported to be 0.7%-29.6% (median 12%), of which 90% are functional constipation. The diagnosis of functional constipation in children is mainly based on the Rome III criteria. The North American Society for Paediatric Gastroenterology and Hepatology and Nutrition developed guidelines for the management of functional constipation in children in 1999, which were updated in 2006 and 2014, and the National Institute for Health and Clinical Excellence (NICE) developed guidelines for the management of idiopathic constipation in children in 2010. Treatment strategies for functional constipation in children include basic treatment, pharmacological treatment, behavioral treatment, surgical treatment, and follow-up. Basic treatment Focuses on family education, dietary modification and lifestyle changes. It is important to drink sufficient amount of water (including water and juice in food), balanced diet (encourage breastfeeding and increase the intake of dietary fiber), appropriate exercise, and reasonable toilet training (5-10 min per day after each meal for children over 4 years old). If basic treatment does not work for 2 weeks, drug therapy should be started. Medication The first choice is oral osmotic laxative (polyethylene glycol or lactulose) or rectal laxative for 3-6 d to relieve fecal impaction and restore regular and comfortable bowel habits as soon as possible. After laxative treatment is completed, maintenance therapy is started to prevent reaccumulation of stool. Maintenance therapy includes dietary modification, medication and behavioral therapy, and can last for 2 months. Medications for the maintenance phase can be osmotic laxatives, stimulant laxatives, stool softeners or rectal administration. Osmotic laxatives are ions or molecules that are not readily absorbed by the intestine and create an osmotic recurrence in the intestinal lumen, keeping water in the intestine; while the added water dilates the intestinal lumen, stimulating peristalsis and softening the stool. Lactulose is indicated for all ages, while polyethylene glycol 4000 domestic is indicated for children over 8 years of age with constipation. Stimulant laxatives mainly increase peristalsis of the large intestine and promote the secretion of water and electrolytes from the distal small intestine and colon to soften stools. There is no information that osmotic laxatives can induce long-term adverse effects, such as electrolyte disturbances and mucosal damage, but there are few reports on the safety assessment of pediatric application of stimulant laxatives. Behavioral, mind-body, conventional and biofeedback therapies are used for specific subjects and are not recommended as a routine treatment for constipation. Probiotics for functional constipation may be beneficial, but there is a lack of high-quality evidence-based evidence. Medication should be considered for dose reduction only if it is effective for 2 consecutive months, and should not be discontinued abruptly. The dose reduction can be maintained for several months to observe the change in stool looseness and frequency of defecation until good defecation habits are established. Surgical treatment For refractory constipation, such as those who are ineffective in medication, chronically constipated or need manual laxation, paracolic colonic enema (cecum stoma) or sigmoidectomy can be performed. The treatment of constipation is long-term and usually recurrent, and parents may seek treatment from multiple hospitals, so follow-up is especially important. Family education and health education should be emphasized to guide a reasonable diet and lifestyle, and the application of non-pharmacological therapies should be emphasized. We should also pay attention to the warning signs and symptoms of constipation and correct the diagnosis in a timely manner. In addition, multidisciplinary association should be strengthened to improve the diagnosis and treatment of functional constipation in children.