Sketch inhibition is regularly alluded to by educators within design higher education and one with increasingly marked effects on industry. Over the past thirty years, students have been observed to engage less with the manual processes of design development process in favour of other activities perceived as more attractive, to the detriment of their development as effective designers. This article offers an evaluation of literature which supports the importance of sketching to the design process across a variety of disciplines, its anatomy and functions and demonstrates its role in cognitive support, as a language, a means of reflection, communication and storage of information and the micro-processes it embodies. Initial findings regarding the symptoms of sketch inhibition are presented: from avoidance of studio sessions and minimal design development, to an overreliance on digital tools. It considers causes, ranging from lacking skill-sets, psycho-social, to technological, and although further investigation is recommended to establish depth and enable development of an appropriate pedagogical framework for its management within HE, various methods are offered at this stage for use by educators: these include fine art exercises, a rigorous pursuit of quantity and even paper type.