Functional constipation is a refractory gastrointestinal disorder influenced by multiple factors and mechanisms，with an imbalance in the brain-gut axis considered a core pathological mechanism.The brain-gut axis serves as a bidirectional regulatory pathway between the brain and gastrointestinal tract，playing a role throughout the disease process.By exploring the relationship between the brain-gut axis and functional constipation，and examining how acupuncture regulated the nervous system，brain-gut peptides，gut microbiota，the hypothalamic-pituitary-adrenal(HPA) axis，as well as traditional Chinese medicine(TCM) theories，this review elucidated the underlying mechanisms through which acupuncture treated functional constipation via the brain-gut axis，aiming to optimize clinical treatment strategies and enhance therapeutic efficacy.