To investigate the current status of family management among children after enterostomy surgery and identify its influencing factors, providing an evidence-based foundation for developing practical resources and policy recommendations to reduce family caregiving burdens and improve postoperative rehabilitation outcomes. This cross-sectional study included 155 pediatric enterostomy patients and their family caregivers from June 2025 to March 2026. Family management and family function were assessed using the Chinese versions of the Family Management Measure (FaMM) and the Family Assessment Device-General Functioning (FAD-GF). We analyzed the clinical data of patients and caregivers, identified factors influencing family management, and conducted statistical analyses on these factors. The average FaMM score was 162.11 ± 11.34, indicating a moderate level. Univariate analysis showed that whether the child was an only child, child's age, family's place of residence, disease course, caregiver education level, employment status, and average family monthly income were all influencing factors (P < 0.05). Pearson correlation analysis indicated a positive correlation between family management and family function (r = 0.934, P < 0.001). Multiple linear regression analysis revealed that family function, disease course, caregiver employment status, and average family monthly income were the primary influencing factors of family management, explaining 77.6% of the total variance. The level of family management among children with enterostomy needs improvement. Better family function, longer disease course, employed caregivers, and higher family income are associated with higher levels of family management. Clinically, it is essential to provide these families with professional information and policy support to enhance their family management capabilities.