Functional abdominal pain can occur in a well-defined clinical entity or as part of a poorly defined clinical syndrome. While the clinician may feel compelled to exclude disease in all cases, we suggest it is more appropriate to take a biopsychosocial approach. In doing so, there can be appreciation of the close interaction of the gut and the brain, allowing the child, family, and physician the opportunity to address the pain on many levels. While the parameters set forth by the pediatric Rome II committee have greatly facilitated our description of these disorders, it is likely that basic research will further delineate biochemical processes in the enteric and central nervous systems that will expand therapeutic horizons.