Companion animal owners are increasingly concerned about the links between degenerative health conditions, farm animal welfare problems, environmental degradation, fertilizers and herbicides, climate change, and causative factors; such as animal farming and the consumption of animal products. Accordingly, many owners are increasingly interested in vegetarian diets for themselves and their companion animals. However, are vegetarian canine and feline diets nutritious and safe? Four studies assessing the nutritional soundness of these diets were reviewed, and manufacturer responses to the most recent studies are provided. Additional reviewed studies examined the nutritional soundness of commercial meat-based diets and the health status of cats and dogs maintained on vegetarian and meat-based diets. Problems with all of these dietary choices have been documented, including nutritional inadequacies and health problems. However, a significant and growing body of population studies and case reports have indicated that cats and dogs maintained on vegetarian diets may be healthy—including those exercising at the highest levels—and, indeed, may experience a range of health benefits. Such diets must be nutritionally complete and reasonably balanced, however, and owners should regularly monitor urinary acidity and should correct urinary alkalinisation through appropriate dietary additives, if necessary.