The topic of surgical sterilization in companion animals is evolving. Although early spay and neuter has been advocated to prevent overpopulation of unwanted pets, recent research has focused on the timing of gonadectomy in relation to risk of various neoplasms, orthopedic conditions, and miscellaneous conditions. Many of these studies are breed-specific or draw from large veterinary medical databases, making it difficult to guide recommendations on the timing of sterilization across various breeds and mixed-breeds. This article attempts to synthesize the data and help guide decision making on the type and timing of sterilization procedures performed, including gonad sparing sterilization surgeries.