In the UK, numerous pedigree dogs of many breeds experience compromised welfare due to the direct and indirect effects of selective breeding. Many breeds are selected to have physical conformations which, although perceived by some to be desirable, have direct negative effects upon their welfare. Dogs are regularly bred whose heads are too large and pelvises too small to birth naturally or whose faces are so flat that they are unable to breathe or exercise normally. There are also many indirect effects of selective breeding for appearance, including significantly elevated prevalence of specific diseases within particular breeds. Current breeding practices can therefore result in unnecessary suffering due to pain, disability, disease and behavioural problems. In this paper, we summarise and review the current scientific evidence for such suffering, and difficulties associated with assessing the impact of current breeding practices. Limited record-keeping, lack of transparency in the breeding and showing world, and the absence of sufficient research, mean that the full extent of the problem is difficult to assess. Furthermore, the collection of data is currently unsystematic, and although there are specific case studies of individual breeds and particular disorders, relatively few have been conducted in the UK. Individual breeds each suffer from their own array of problems, so each breed's survival and improvement (in terms of health and welfare) is likely to require a different specific course of action. With 209 breeds currently registered in the UK, this makes the situation complex. We collate and present a range of suggestions which may help to improve pedigree dog welfare significantly, and prioritise these based on expert opinion.