Sterile granulomatous and pyogranulomatous dermatitis are a heterogeneous group of canine and feline skin conditions (e.g. granulomatous-pyogranulomatous syndrome, sebaceous adenitis etc.) that share the same type of inflammatory infiltrate and the lack of an infective or parasitic cause. Despite these similarities they display different clinical pictures, disease course and response to treatment. When dealing with sterile granulomatous and pyogranulomatous dermatitis the main diagnostic and therapeutic challenges include the recognition of a suggestive clinical picture, the exclusion of detectable infective causes and the therapeutic long-term management. Special attention will be given to the variability of the clinical picture that characterizes this group of diseases.