Urinary tract infections (UTIs) are among the most common bacterial infections in pediatric patients and a frequent reason for primary care consultation. While isolated episodes are usually managed empirically, recurrent UTIs may indicate underlying anatomical or functional disturbances. Functional bowel–bladder dysfunction, particularly constipation, is increasingly recognized as a reversible risk factor, especially in female pediatric patients. Early recognition in primary care is essential to prevent recurrence and reduce unnecessary antibiotic exposure.A 7-year-old female pediatric patient presented after a third UTI episode within eight months. Symptoms included dysuria, urinary frequency, and low-grade fever. Previous episodes had been treated empirically without microbiological confirmation or imaging. Urinalysis showed leukocyturia, and urine culture grew Escherichia coli sensitive to first-line antibiotics. History-taking revealed chronic constipation. Renal and bladder ultrasonography showed no structural abnormalities but incomplete bladder emptying, consistent with functional bowel–bladder dysfunction. Management included culture-guided antibiotics, a bowel regimen, and counseling on hydration, regular voiding, and toileting. No further UTIs occurred during six months of follow-up.This case highlights constipation as a modifiable functional contributor to recurrent UTIs identified in primary care. Unlike reports focused on anatomical anomalies or specialist-led evaluations, it demonstrates how comprehensive history-taking and non-invasive assessment can guide effective management.Constipation may increase bladder pressure, impair emptying, and promote urinary stasis, facilitating infection. Assessing bowel habits in children with recurrent UTIs may reduce recurrence and support antibiotic stewardship. Integrating bowel–bladder evaluation into primary care can improve long-term outcomes.Functional bowel–bladder dysfunction is a well-documented but often underrecognized contributor to recurrent UTIs. Fecal retention can mechanically and functionally interfere with bladder emptying, increasing post-void residual urine and infection risk. Studies demonstrate a significant association between constipation and recurrent UTIs, with improvement after bowel management. Pediatric guidelines emphasize assessing bowel habits as part of the evaluation for recurrent UTIs, particularly in female patients.Recurrent UTIs in pediatric patients warrant further diagnostic evaluation in primary care. Early recognition and management of constipation and bowel–bladder dysfunction can prevent recurrence, limit unnecessary antibiotic use, and enhance quality of care.