Constipation is a common emergency department (ED) chief complaint encompassing various gastrointestinal concerns. A focused history and physical should screen for dangerous mimics, dangerous causes, and dangerous complications. If red flags are absent, laboratory studies and abdominal imaging are generally unnecessary as functional constipation is a clinical diagnosis. Disimpaction with oral or enema therapy may start in the ED but requires outpatient therapy for success. Oral and enema therapies are safe, but emergency physicians should be aware of specific contraindications and potential adverse events before initiating.