Urban and suburban deer populations are expanding across North America and Europe, creating human-wildlife conflicts including road collisions, garden damage, and disease transmission (Lyme disease). Management options include lethal culling, reproductive control (PZP contraception), translocation, and habitat modification. Welfare considerations are central to management choice: lethal control raises concerns about pain and injury from wounding; contraception programmes require repeated darting causing short-term stress; translocation carries mortality risk of 10–30%. Research supports targeted lethal control with trained operators as the most welfare-efficient option for large populations. Immunocontraception shows promise for small isolated populations. Community engagement and welfare-transparent communication are essential for public acceptance.