Brachycephalic dog breeds are popular around the world, yet many brachycephalic dogs are affected by numerous health problems, including several head-related diseases that are directly linked to their conformation. In addition to the well-recognized disorders associated with the respiratory system (brachycephalic obstructive airway syndrome, i.e., BOAS), brachycephalic dogs have a concerningly high prevalence of ocular surface disorders that can cause chronic discomfort, loss of the globe, and/or require long-term, daily therapy. This review offers a summary of the physiological and anatomical features of brachycephalic ocular syndrome (BOS) that predispose brachycephalic dogs to develop ocular surface disease, followed by a concise description of common ocular diseases associated with BOS. It ends with an overview of evidence-based guidelines and animal welfare legislation that some in the veterinary community have already implemented but that requires a wider, international effort in order to reduce the prevalence of BOS-associated disorders and improve the ocular health of affected dogs.© 2022 The Authors. Veterinary Ophthalmology published by Wiley Periodicals LLC on behalf of American College of Veterinary Ophthalmologists.