Purpose of Review <p>Irritable bowel syndrome (IBS) is a common disorder of gut-brain interaction (DGBI) in pediatrics. In IBS, the bidirectional relationship between the central nervous system and the enteric nervous system is altered. Gut dysmotility, changes in the gut microbiome, diet, and psychosocial factors play an integral role in the pathophysiology of IBS. A biopsychosocial approach is, therefore, paramount to the management of IBS. This article provides a comprehensive review of the strategies available to clinicians.</p> Recent Findings <p>Effective patient-physician-family communication is the cornerstone of any successful therapeutic regimen for IBS. Timely and clear communication of the diagnosis and treatment options is essential. Regarding therapies, there is a degree of trial and error involved as therapy plans are tailored to each individual patient. Current treatment options include dietary modifications, pharmacologic agents, nerve field stimulating devices and, importantly, psychological therapies such as cognitive behavioral therapy and gut-directed hypnotherapy.</p> Summary <p>There is no singular treatment algorithm for pediatric patients with IBS. A combination of dietary interventions, pharmacologic agents and emerging modalities such as nerve stimulating devices, combined with strong psychosocial support, offers a growing toolkit for the clinician.</p>