Opioid-induced constipation (OIC) is the most common adverse effect of opioid analgesics. Its treatment is difficult and depends to a large extent on multiple overlapping dietary, behavioral, disease-related, and iatrogenic causes. The prevention of constipation is mandatory, along with the initiation of opioid use. In the treatment of OIC, regular laxatives are recommended, despite their poor effectiveness. In the case of ineffectiveness, one of the peripherally acting m opioid receptor antagonists (PAMORA), such as methylnaltrexone, naloxegol, or naldemedine, should be used. After achieving bowel movements, the treatment with antagonist should be continued.