Noise in quantum computing is countered with quantum error correction. Achieving optimal performance will require tailoring codes and decoding algorithms to account for features of realistic noise, such as the common situation where the noise is biased towards dephasing. Here we introduce an efficient high-threshold decoder for a noise-tailored surface code based on minimum-weight perfect matching. The decoder exploits the symmetries of its syndrome under the action of biased noise and generalises to the fault-tolerant regime where measurements are unreliable. Using this decoder, we obtain fault-tolerant thresholds in excess of 6% for a phenomenological noise model in the limit where dephasing dominates. These gains persist even for modest noise biases: we find a threshold of ∼ 5% in an experimentally relevant regime where dephasing errors occur at a rate one hundred times greater than bit-flip errors.The surface code [1,2] is among the most promising quantum error-correcting codes to realise the first generation of scalable quantum computers [3][4][5]. This is due to its two-dimensional layout and low-weight stabilizers that help give it its high threshold [2,6,7], and its universal set of fault-tolerant logical gates [2,[8][9][10][11]. Ongoing experimental work [12][13][14][15] is steadily improving the surface code error rates. Concurrent work on improved decoding algorithms [6,7,[16][17][18] is leading to higher thresholds and lower logical failure rates, reducing the exquisite control demanded of experimentalists to realise such a system.Identifying the best decoder for the surface code depends critically on the noise model. Minimum-weight perfect matching (MWPM) [19,20] is near-optimal in the case of a bit-flip error model [2] and for a phenomenological error model with unreliable measurements [6]; see [21,22]. More recently, attention has turned to tailoring the decoder to perform under more realistic types of noise, such as depolarising noise [16,18,23,24] and correlated errors [25][26][27]. Of particular note is noise that is biased towards dephasing: a common feature of many architectures. With biased noise and reliable measurements, it is known that the surface code can be tailored to accentuate commonly occurring errors and that an appropriate decoder will give substantially increased thresholds [28,29]. However, these high thresholds were obtained using decoders with no known efficient implementation in the realistic setting where measurements are unreliable.Here we propose an efficient decoder for the surface code that is tailored to correct for local noise biased towards dephasing, demonstrating exceptional fault-tolerant thresholds. Our decoder uses the MWPM algorithm together with a recent technique to exploit symmetries of a given quantum errorcorrecting code [30]. Rather than using the symmetries of the code, we generalize this idea and use the symmetries of the entire system. Specifically, we exploit the symmetries of the syndrome with respect to its incident error model. Applied to pure depha...