Treatment of sarcoids is often challenging, due to the variable clinical presentation of lesions and thefrequent local recurrences. In this article, both the surgical and the non-surgical treatment of equine sarcoidsare reviewed. It is generally accepted that the prognosis is worse if unsuccessful attempts have beenmade previously. Therefore, the best available treatment option should always be used at the first attemptof treatment. Different surgical approaches have been reported, including conventional excision, cryosurgeryand CO2 laser surgery. Success rates are high if a non-touch approach, wide surgical margins andgeneral anesthesia can be applied. Local chemotherapy is a valuable addition in the treatment of sarcoidsand can be combined with surgery. Radiotherapy is a very successful treatment, but safety precautionsprevent routine application. Local immunotherapy including Bacillus Calmette-Guérin vaccination andimiquimod cream are commonly applied treatments which induce rather effective tumour regression.