The criteria for the use of long-term oxygen therapy in chronic obstructive pulmonary disease are well established, but there is variability in prescribing habits, poor adherence to guidelines, and lack of organised follow-up and monitoring arrangements. This report gives new guidance on the use of domiciliary oxygen in adult patients with chronic respiratory disease and indications for its use in paediatrics, cardiology and palliative medicine. New methods of prescribing are also recommended.