Functional dyspepsia (FD) is a common chronic functional gastrointestinal disorder in pediatrics, categorized under traditional Chinese medicine (TCM) concepts such as "epigastric pain". The theory of "Zang-Fu Meridian Mutual Communication" was proposed by Li Yan in the Ming Dynasty in his work Introduction to Medicine (Yixue Rumen). Its core tenet lies in the mutual communication of qi transformation among Zang-Fu organs, among which the theories of "spleen communicating with small intestine" and "stomach communicating with pericardium" are closely related to the pathogenesis of pediatric FD. Children are characterized by "innate spleen insufficiency" and "unstable mental state". Due to improper diet, emotional fluctuations and other factors, they are prone to forming a bidirectional pathological cycle: dysfunction of spleen transportation combined with disordered separation of clear and turbid substances in the small intestine, as well as failure of stomach to descend harmoniously accompanied by stagnation of pericardial qi movement. This constitutes the core pathogenesis of the disease. The treatment should adhere to the principles of regulating the mutually communicating Zang-Fu organs and balancing qi movement, while taking into account children"s inherent characteristics of "immature yin and immature yang". Modified formulas such as Qiwei Baizhu Powder (Seven-Ingredient Atractylodes Powder) can be selected, thereby providing a new approach for the TCM syndrome differentiation and treatment of pediatric FD.