Objective To analyze the effects of two surgical procedures on the postoperative complications and defecation function of patients with different pathologic types of Hirschsprung disease (HD). Methods The early postoperative complications of 101 children with HD who underwent radical procedures were retrospectively analyzed. The defecation function (Krechenbeck scores) and stooling frequency of 87 followed up cases were evaluated 6, 12, and 24 months after radical procedures. The relationships of two surgical procedures, different pathologic types, postoperative complications, and defecation function were assessed. Results The rate of early postoperative constipation of the Soave procedure (11.76%) was significantly higher than that of the Ikedasoper procedure (2.78%), while the rate of early pelvic inflammation complication of the Ikedasoper procedure (8.33%) was significantly higher than that of the Soave procedure (0%). The differences were statistically significant (P<0.05). The rate of postoperative complications increased with the severity of pathologic types. The defecation function improved with time. The differences of defecation function of different groups were not statistically significant 24 months after surgery (P>0.05). Conclusion Selection of the most appropriate procedure and management of postoperative diet and defecation are key points for the treatment of HD.