A thorough neurologic examination is required when a horse shows signs of neurological diseaseor when it has to be confirmed that the horse is neurologically normal. The main purpose of the examinationis to investigate whether there are neurological deficits. In addition, the identification ofthe primary cause and localization of the lesion should be attempted. A standardized head-to-tail approachhelps to avoid overlooking important lesions. Therefore, the examination always starts witha thorough patient history, observation of the horse with special attention to mental state, behavior,posture and stance, and a clinical examination. Subsequently, the cranial nerves are tested by investigating,amongst others, the menace, light and palpebral responses. The neck, trunk, limbs and tail areexamined for asymmetry or hypo- or hypersensitivity. Afterwards, the movements of the horse areinspected. Incoordination of the horse is accentuated during transitions, small circles and zig zag lines.However, the difference with orthopedic problems is not always easy to make. Especially horses inlateral recumbency present an extra challenge as recumbency itself may cause a change in responses.Further examinations are often necessary to confirm neurologic disease or to visualize a lesion. Bloodexamination (general, serology, virus isolation), liver or muscle biopsies, examination of cerebrospinalfluid and radiographs are feasible to perform in practice. In specialized hospitals, electro-diagnostictests and advanced medical imaging (CT, MRI, scintigraphy) are available. By combining these techniqueswith the clinical neurologic examination, a (differential) diagnosis can be made.