This article reviews the pathogenesis, diagnosis and therapeutic options for the respiratory aspects of brachycephalic obstructive airway syndrome. Brachycephalic obstructive airway syndrome is a condition estimated to affect around 50% of the brachycephalic dog population, which, over recent decades, has seen a meteoric rise in popularity and ownership. Several primary and secondary respiratory abnormalities that can compromise the respiratory capacity of these patients should be considered. Diagnosis primarily takes the form of clinical examination and the use of an exercise tolerance test, with other diagnostics acting as a useful adjunct in fully detailing the abnormalities present. Treatments are mainly focussed on increasing the amount of space within the upper respiratory tract through removal of various primary and secondary anatomical abnormalities; however, the optimal methods are yet to be identified. While understanding of these breeds' respiratory issues has increased among owners and the veterinary profession, there are still many challenges and unknowns in the management of these patients. It is important veterinary professionals take an active approach to these patients and are able to effectively communicate which are affected in order to maximise the welfare of this cohort and uphold their ethical responsibilities to them.