Brachycephalic breeds are often in the news due to the challenges and ethical issues surrounding conformation-related disease in these breeds. An exponential rise in ownership of brachycephalic breeds has occurred in recent years, particularly of French bulldogs, where kennel club registrations have increased by 3000 per cent over the past 10 years in the UK. The increase in popularity of these breeds has led to increased awareness of conformation-related health issues seen in some brachycephalic dogs. Brachycephalic obstructive airway syndrome (BOAS) is perhaps the most obvious conformation-related health issue, but other welfare issues include: skin fold pyoderma; shallow orbits with protruding globes, leading to increased risk of corneal ulceration and globe prolapse; hemivertebrae, which may be accompanied by spinal cord compression; Chiari-like malformation; dystocia; and dental malocclusion. Upper airway obstruction, or BOAS, has been predominantly documented in extreme brachycephalic breeds, specifically the bulldog, French bulldog and pug. BOAS may manifest as respiratory noise, dyspnoea, exercise intolerance, heat sensitivity, sleep disorders, cyanosis or collapse.1 The prevalence of these diseases among the brachycephalic breeds is difficult to assess as many are not recognised by owners2 and some are accepted by veterinary surgeons as normal for the breed. Although many breeds, including the French bulldog, pug and bulldog, have health schemes which the breed clubs are promoting, only a small proportion of the pet population is Kennel Club registered. The increased demand for these dogs has resulted in a lucrative puppy trade where the focus may be on money rather than health. The general practice surveillance data generated from schemes such as VetCompass have shown that extreme brachycephalic breeds die younger than equivalent sized dogs, with a higher proportion of deaths due to upper respiratory disease.3 However, the value of such information depends on accurate, consistent reporting of lesions which, …