Veterinary professionals (VPs) are often the first source of advice for clients struggling with their dog's behaviour, and pulling on the lead is a commonplace undesirable behaviour VPs will encounter regularly in practice. Excluding bites, being pulled over while walking on a lead is the leading cause of non-fatal dog-related injuries in the UK. This narrative review investigates lead pulling as a welfare concern in pet dogs, highlighting aspects of the literature of particular interest to VPs. Lead pulling could negatively affect walk quality, frequency and duration, causing weight gain, while decreased environmental enrichment could trigger other undesirable behaviours. Aversive equipment to prevent lead pulling can cause pain, distress and injury, but even equipment considered humane can have welfare consequences. Punitive training methods could cause dogs stress, fear and anxiety and trigger aggressive behaviour. While these lead pulling outcomes are welfare concerns in themselves, they could also weaken dog–owner attachment, a risk factor in pet dog relinquishment. Given lead pulling could affect the welfare of patients in a VPs care, clinical implications and opportunities for client education are outlined. Educating clients on humane prevention and modification of lead pulling could make walks easier, safer and more enjoyable, with positive outcomes for clients, canine welfare and the practice.