BACKGROUND Functional constipation (FC) is a common condition among children worldwide. Although the Rome IV criteria are diagnostic standard, evaluating infants and toddlers can be challenging. The Bristol stool chart (BSC) is a simple tool for describing stool consistency, but its diagnostic accuracy in young children is uncertain. AIM To compare the diagnostic performance of the BSC and Rome IV criteria in children under four years. METHODS A prospective cross-sectional study was conducted fr