Congenital megacolon is a malformation of the gastrointestinal tract that presents with delayed expulsion of meconium after birth (more than 24 hours), vomiting, constipation, abdominal distention, and in severe cases, fever, diarrhea, and dehydration. The cause is a lack of neurons in the rectal or colonic canal, resulting in spastic narrowing of the rectum or colon, and consequent dilatation of the proximal canal. Children can sometimes defecate on their own, but not completely, and with the accumulation of gas in the intestine, the abdomen is often distended like a drum. Generally, a large amount of feces and gas can be expelled with the administration of a cork or enema, and the abdominal distension will improve significantly. Some children have poor results and require emergency surgical fistula. Wang Xiang, Department of General Surgery, Children’s Hospital, Zhejiang University School of Medicine Once the diagnosis of megacolon is clear, surgical treatment is required. Depending on the age of the child, the extent of the stenotic and dilated intestinal canal or the physical condition of the child, and the level of the hospital where the child is seen, there are various surgical methods. The most popular methods include transanal surgery (no scars on the abdomen) and laparoscopic surgery (minimally invasive surgery with small scars). Most of the surgical results are good, and the child can live and develop normally. Some children develop various complications after surgery, and some require reoperation.