The purpose of a recent study published in The Journal of Pediatrics was to identify the reasons why pediatric gastroenterologists obtain abdominal radiographs for pediatric patients with constipation. This was a prospective study which surveyed providers regarding their rationale, interpretation, resultant change, and confidence in their management before and after obtaining kidney, ureter, and bladder X-rays in patients seen for suspected constipation. Here, 24 providers were surveyed after 72 patient encounters. Reasons for obtaining an abdominal radiograph included evaluation of stool burden, need for a clean out, fecal impaction, cause of abdominal pain, demonstration of stool burden to families, assessment of response to therapy, or encopresis. Treatment plans were modified in 47.6% of cases based on radiographic findings. It was found that provider confidence in the management plan increased after an abdominal radiograph. Hence, it was inferred that abdominal radiographs commonly are obtained by pediatric gastroenterologists during evaluation and management of constipation. The majority used it to make a diagnosis, and about one-half changed their management based on the imaging findings.