Untreated house soiling presents a severe risk to the human-animal bond. Despite being one of the most common behavior problems reported to veterinarians, a majority of veterinarians surveyed reported a lack of confidence in their ability to diagnose nonmedical inappropriate elimination. Successful resolution depends on an appropriate diagnosis, which is arrived at by a thorough medical and behavioral history, once medical problems have been ruled out. A systematic approach to collecting history, noting clinical signs and ruling out differentials, is most likely to yield positive results in the shortest time.