Objective To investigate the long-time efficacy of operation for elder children with constipation. Methods Clinical data of 14 cases of elder children (beyond 10 years old) with constipation who all accepted operative therapeutics in our department were retrospectively analyzed, and theirdefecation frequency and stool character were evaluated during follow-up term. Results These 14 children, including 9 males and 5 females, were aged from 10 to 18 years old with an average of 12. 8 years. The pathological diagnosis after operation confirmed that there were 9 cases of Hirschsprung's disease, 2 cases of intestinal neuronal dysplasia (IND), 2 cases of redundant sigmoid colon and 1 case of hypoganglionosis. Ten cases underwent the partial colectomy and pullthrough coloanal heartshape anastomosis, 3 cases underwent the Soave operation and 1 case with the modified Rehbein operation. All these children were recovered from operation without anastomotic leakage or stenosis. One child with IND, who underwent the laparoscopic assisted partial colectomy and pullthrough coloanal heartshape anastomosis operation, suffered from constipation again after operation. After the second operation, light stool incontinence happened to this child. All of the other children were followed up for 2 to 12 years and they all had normal stool frequency. The enterocolitis after operation appeared in 4 cases and they were all recovered after conservative treatment. Conclusions There are various causes for the constipation in elder children. The satisfactory therapeutic effect can be achieved after rational operation adopted for elder children with constipation.