Objective To evaluate the magnitude and direction of radial torsion (RT) in dogs with medial compartment disease (MCD). Study design Case‐control study. Sample population Twenty‐eight healthy dogs and 28 dogs with confirmed MCD. Methods Computed tomography images of each dog's antebrachium were evaluated. Radial torsion was measured by using previously described landmarks on the proximal and distal radius. Differences between groups were tested with Student's t tests and Wilcoxon rank‐sum tests. Results Healthy dogs had a mean RT angle of 3.44° (range, 1.28°‐5.44°). Dogs with MCD had a mean RT angle of 11.84° (range, 2.31°‐26.55°). Both groups included similar proportions of dogs with external (76% vs 77%) and internal (24% vs 23%) torsion. The direction of torsion (P = .21 and P = .69) did not appear to affect the magnitude of the RT angle. Conclusion Dogs with MCD had an increased RT angle compared with healthy controls. The direction of torsion varied similarly between groups regardless of the disease status of dogs in this study. Clinical significance The fourfold increase in the RT seen in dogs with MCD may contribute to the rotational overload proposed recently, potentially modifying the orientation of the elliptical radial head and the ligaments crossing the elbow joint.