Summary: Functional constipation is a common problem in the pediatric population. When fecal impaction is present, disimpaction with polyethylene glycol (PEG) or rectal enema is required. For maintenance therapy, the use of PEG is recommended, or lactulose if PEG is not available. In patients with alarm symptoms suggesting an organic disease or constipation unresponsive to therapy, referral to a pediatric gastroenterologist is needed.