Obstructed defecation syndrome is a common, well-defined type of functional constipation. It is characterized by excessive straining at stool, incomplete rectal evacuation, and need for perineal splinting. It is often identified in association with various manifestations of pelvic organ prolapse. Symptoms of obstructed defecation are primarily treated non-operatively with dietary fiber and hydration, modest exercise, and pelvic floor physical therapy. Traditional surgical approaches for pelvic organ prolapse have proven relatively ineffective at managing obstructed defecation. New surgical approaches such as ventral mesh rectopexy, stapled transanal rectal resection, and sacral nerve stimulation may ultimately prove to be more effective at relief of the symptoms of obstructed defecation.