<p>The popularity of brachycephalic (flat-faced) dog breeds remains high despite growing welfare concerns associated with their conformation. While the appeal of brachycephalic dogs has been described, there has yet to be a formal systematic review and thematic analysis of owner perceptions of these dogs. A systematic review via thematic analysis of owner perceptions of brachycephalic dogs was performed to better understand their sustained popularity. CAB Abstracts, Pubmed, Web of Science and Google Scholar were searched up to March 2025 for studies that investigated owner perceptions of their brachycephalic dogs. Descriptive codes were identified from 15 eligible studies and grouped to generate major themes. Four major themes of owner perceptions were identified: the health of the dog, the human-animal relationship, the appearance of the dog and welfare concerns. Owner perceptions of health were the factors most frequently reported. Overlapping themes in each study reviewed highlighted the normalisation of health issues, deprioritising health, and the influence of positive perceptions of brachycephalic breeds as important factors of ownership. This research outlined some of the likely beliefs, priorities and motivations that underpin the demand for brachycephalic dogs. When developing owner-targeted interventions to reduce the impact of conformational health and welfare issues on brachycephalic dogs, these themes are potentially important factors to be considered.</p>