Childhood constipation is a common and often distressing condition affecting both the child and their family. It is frequently encountered in primary care settings and, if not managed effectively, can lead to significant physical and psychological morbidity. Effective management hinges on a comprehensive approach that encompasses assessment, diagnosis, treatment, and understanding the psychological impacts. This article covers the critical aspects of assessing and diagnosing childhood constipation, including abdominal examination, recognising red flags and differential diagnoses, further investigations, and the psychological implications of the condition. It also delves into the causal reasons for childhood constipation, its effects on the child’s well-being, parental frustrations due to poor management, and treatment options available.