This document discusses puppy mills, which are large commercial dog breeding operations that raise puppies for profit in inhumane conditions. It defines puppy mills and outlines some of the common health problems seen in puppies from these operations. It discusses the history of puppy mills and how they operate, circumventing regulations. It summarizes the Animal Welfare Act and challenges with enforcement. Finally, it provides recommendations for strengthening laws and regulations to better protect puppies bred in these types of facilities.