Constipation is a common disease with different treatment modalities depending on its etiology. Currently, the main treatments include: recommending a reasonable dietary structure, establishing correct fecal habits, adjusting the patient’s mental and psychological state, medication and surgery. Generally speaking, constipation can be divided into organic and functional. The main organic lesions that cause constipation are idiopathic megacolon and ganglion cell deficiency, for which surgical treatment is generally necessary to solve the problem at its root. Most patients with constipation are functionally constipated and are classified as slow-transmission constipation, outlet obstruction constipation, and mixed constipation. The mechanisms leading to functional constipation are not yet clear, and patients who fail conservative medical treatment still require surgical intervention. Patients with constipation have similar clinical manifestations, and in order to achieve good results in surgical treatment, the first step should be to make full use of clinical adjuvant examinations to clarify the diagnosis and to select the appropriate surgical approach as well as to control the surgical risks for the different types. Today, we will focus on the surgical treatment of functional constipation. Patients with slow-transit constipation can usually achieve a certain degree of success with early conservative treatment, but some long-term use of laxatives leads to progressive disease until surgical intervention is required. At present, ascending colorectal anastomosis is more commonly used in China as the main surgical treatment for slow-transit constipation, and its efficacy has been reported in the literature to be good. Outlet obstructive stools can include anterior rectal protrusion, perineal descent, and pelvic floor muscle spasm, which may be caused by one or more causes. Non-surgical methods are preferred for treatment, and most patients can be improved by lifestyle adjustments, and biofeedback therapy can be used for patients with abnormal pelvic floor muscle function. Surgical treatment of outlet obstruction type constipation is generally not effective. The surgical treatment of endorectal prolapse can be performed by transanal anastomotic proctocolectomy (sTARR), which has been widely used in the surgical treatment of endorectal prolapse and has achieved good results. The early cause of constipation in many patients is simple slow transmission or outlet constipation, but as the disease progresses, the two types of constipation can form a mixed constipation. The number of patients with mixed constipation is large, with the proportion reported in China ranging from 56% to 90%. The surgical treatment of mixed constipation is most representative of the research on this disease by Li Ning’s team in China. The Jinling procedure proposed by the team has achieved good near and long-term results, which is based on the principle of removing the slow-transmitting bowel segment and preserving good fecal storage function by lateral anastomosis of the rectum and ascending colon. Due to the complex etiology and pathophysiological process of constipation, a single treatment method often fails to achieve better treatment results. Multidisciplinary treatment (MDT), such as gastroenterology, nutrition, preventive health care, gastrointestinal surgery and anorectal medicine, can be used to develop a more accurate treatment plan for patients, thus improving the diagnosis and treatment results.