Although idiopathic constipation is one of the commonest problems in childhood, it is often the most poorly managed.Left untreated, constipation can become chronic and result in devastating problems, including soiling, as well as pain and distress for the child and family. The recent NICE guidelines on the management of idiopathic constipation in children and young people not only provide evidence-based strategies for the improvement of assessment and treatment but may also lead to service improvements, with potential cost savings, by reducing the need for secondary care interventions. This article will give an overview of the management of functional or idiopathic constipation in childhood while reflecting on the NICE guidelines and discussing the keys to successful treatment.