Childhood constipation is a prevalent issue globally. Certain children experience persistent constipation and soiling, either as a result of surgical repair of anorectal malformations or underlying medical conditions that present management challenges. These refractory cases of constipation significantly affect the psychological well-being of both patients and their families. The available treatment options for refractory constipation are not clearly established. However, prompt and appropriate management of constipation contributes to an enhanced health-related quality of life. This article explores the current modalities available for treating children with challenging constipation and examines their impact on health-related quality of life.