Textile Exchange has been championing organic cotton within the textile industry for over sixteen years now, pioneering an integrity and standards division with the aim of continuous improvement, long before it became fashionable to do so. It’s clear from discussions over the last few years that integrity has surfaced as a “hot topic” that warrants further effort. With so many groups acting to address the integrity issue, it was determined that we needed to take a step back and get an external perspective. We asked – are the actions that are being taken really addressing the issues – or only the symptoms? Where should we focus our efforts? This report offers an honest account of the current concerns facing the organic cotton sector. It is not designed to “name and shame” but rather as an opportunity to lay the symptoms of deeper systemic issues in integrity on the table so the sector can come to terms with the problems and move forward. We know the benefits and potential of organic remain sound; it will be up to the community to take the learnings from this report and act collectively to address the root causes. There is a role for everyone but action needs to be taken now. The future of a strong and thriving organic cotton sector, that implements regenerative agriculture and builds resilient communities, is a future worth our collective effort.