Biomedical scent detection dogs identify the scent profiles of diseases, such as cancer, diabetes or pathogenic micro-organisms. What the field of biomedical scent detection has been lacking, however, is the assessment of the method from the point of view of a health technology. All health technologies undergo a thorough evaluation of safety, clinical effectiveness and costs, as well as ethical, social, organizational and legal evaluations in some cases. Passing these regulatory controls is a pre-requisite before a technology is approved for use in decision-making about patient outcomes. Biomedical scent detection has a lot of attractive qualities, such as the sensitivity and specificity of the dogs’ noses, safety and relative cost-effectiveness. However, the method also has various challenges, in particular regarding its clinical effectiveness. The most pertinent issues to address before the dogs would pass as a health technology are standardization of the training techniques, both intra- and inter-dog reproducibility, and generalization of the detection task to the early stages of disease progression. We recommend setting realistic goals in terms of what the dogs can and cannot do and adopting a collaborative approach between clinicians and animal psychophysicists.