Elbow dysplasia is a common debilitating condition of large and giant breed dogs. Environmental factors and a complex genetic heritability play a role in predisposing dogs to elbow dysplasia with two aetiopathogeneses suggested for the development of the disease. Osteochondrosis was initially thought to cause elbow dysplasia, but more recent evidence has strongly supported various forms of joint incongruity as the most likely cause in most cases. Radioulnar length discrepancies and humeroulnar curvature mismatch have been implicated as the cause of medial coronoid disease and ununited anconeal process, but radial incisure incongruity and biceps/brachialis muscle forces could possibly play a role in some dogs.Treatment of elbow dysplasia should address articular pathology, such as fragmented coronoid process, osteochondrosis, cartilage damage and ununited anconeal process as well as any identified underlying causes. Finally, several palliative procedures have been developed to address more advanced elbow disease and might offer improved outcomes compared to conventional medical management.