In different parts of the world the claim is increasingly being made that continuous confinement of pet cats (Felis catus) is beneficial for both wildlife conservation and cat welfare. The first part of the claim is almost incontrovertible, but the second is misleading. The assertion that confined animals have superior welfare is rooted in thinking pre-dating the 1960s that equates welfare with physical health. By contemporary accounts of animal welfare, confinement of animals presents major welfare risks, and this recognition has been a major driver of refinement in livestock industries, e.g. moves towards free-range systems. Yet, these risks have not been widely acknowledged in debates over pet cat management. We argue that the current pervasive rhetoric from conservationists and some regulators that cat confinement is beneficial for wildlife and cats is, at best, confusing health with welfare. At worst, it is a deliberate attempt to mislead the public through portraying a win-win scenario where, instead, a trade-off must be navigated. Failure to recognise this trade-off undermines conservation goals three-fold. First, it limits the efficacy of behaviour change interventions to increase confinement. Second, it erodes public trust in organisations perceived as knowingly misleading the public. Finally, it reduces the incentive to make the one decision yielding long-term benefits for both cats and ecosystems; ceasing to own cats at all. Policy-makers should be wary of the allure of false win-win narratives when tackling contentious issues that require trade-offs to be made.