Constipation is common in young children and results in approximately 350 hospitalisations per 100,000 population for 0-4-year-olds. Constipation can become chronic in more than one-third of those affected. The purpose of this article is to provide an awareness and highlight the care planning, diagnosis and management in paediatric functional constipation. It is intended for general practitioners and those in primary healthcare who may be unfamiliar with functional constipation. Paediatric functional constipation affects the child's physical, psychological and social wellbeing while causing significant stress to the caregiver/whānau. Despite its prevalence, functional constipation is often misdiagnosed and inadequately treated. Functional constipation requires a comprehensive therapeutic plan, including education, behavioural intervention and medication. Pharmacological treatment often causes concern and misapprehension for developing 'dependence', which is unfounded. Children with chronic constipation who do not progress, despite aggressive medical therapy and behavioural modification, may benefit from further assessment with colonic transit or anorectal and colonic manometry. In the future, novel medical, exercise and surgical strategies will have a role in advancing improved outcomes in children who are unresponsive to conventional medical and behavioural interventions. However, this will require more evidence-based guidelines. Unresponsive constipation cases should be included in the care planning of district health boards, which may assist in a multidisciplinary approach to assisting the physical and psychosocial aspects of constipation.