Obstructed defecation syndrome (ODS) is a complex and multifactorial problem which significantly impairs quality of life of patients. The treatment journey begins with the challenge of establishing an accurate relationship between symptoms and pathophysiology, which is critical for effective management. This talk will delve into the intricacies of diagnosing ODS though anorectal manometry and defaecating proctograms which aid in unravelling the structural and functional abnormalities contributing to the disorder. The importance of a multidisciplinary approach is highlighted. The therapeutic options ranging from conservative management with dietary modifications and biofeedback therapy to advanced surgical interventions are discussed. There is a necessity for individualised treatment plans, tailored to address the specific needs and circumstances of each patient.