Symmetrical alopecia in dogs can be a clinical presentation that is frustrating to address in daily practice. A complete work-up should include evaluating the breed characteristics, taking a complete history and carrying out a complete physical and dermatological evaluation. A list of differential diagnoses should help to decide which diagnostic tests should be performed to rule out ectoparasites, infections, endocrine disorders and follicular disorders. The treatment options should be discussed with the owners because, for some alopecic conditions, e.g. follicular dysplasia, there may be no effective therapy and the alopecia may be just a cosmetic disorder.