Fecal incontinence (FI) is defined as “the involuntary or uncontrollable loss of feces through the anus.” In the 2017 edition of Japanese Clinical Guidelines for Fecal Incontinence, its prevalence is estimated at approximately 10% in the general population. It is usually caused by multiple etiologies and factors including stool consistency, function of defecation-related musculature, anorectal sensory function, rectal pressure·capacity·compliance, colonic function, and cognitive and mobility function. To diagnose its underlying causes, medical history taking and physical examination are essential, followed by specialized examinations including anorectal physiology examinations and endoanal ultrasonography. FI can be classified into passive and urge types based on symptoms. After excluding organic causes, initial management should be tailored to the symptom type, underlying cause, and severity—beginning with dietary, lifestyle, and bowel habit guidance, as well as pharmacotherapy. If these initial treatments fail, referral to a specialized facility is recommended. Specialized conservative therapies include pelvic floor muscle training, biofeedback therapy, and transanal irrigation. If these conservative therapies fail, surgery treatment should be considered. First-line surgical procedures include sacral neuromodulation and sphincteroplasty, while second-line surgical procedures include antegrade continence enema, graciloplasty, ventral rectopexy, and stoma creation. Anal sphincter regenerative therapy is emerging as a promising experimental therapy.