A 1-year-old mixed breed presented with previously diagnosed hip dysplasia and decreasing activity levels. Her physical exam and blood work were within normal limits. On orthopedic examination, severe elbow effusion with decreased range of motion and pain on manipulation were detected bilaterally. She seemed most painful in her elbows, so they were prioritized over her other orthopedic abnormalities. Bilateral elbow radio graphs from the referring veterinarian increased suspicion of elbow dysplasia, specifically medial compartment disease. Bilateral elbow arthroscopy was elected to definitively diagnose and treat her medial compartment disease. Canine elbow dysplasia is a common disease seen by small animal veterinarians. This paper focuses on the diagnosis, arthroscopic treatment, and outcome of a case of medial compartment disease.