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Although equine laminitis has apparently been known for more than 2000 years (Heymering, 2010), the disease is still not completely understood and requires further research. Numerous treatment strategies are applied, but the overall success rate is still unsatisfactory. Furthermore, the establishment of an efficient treatment plan is complicated by the diversity of underlying diseases and the individual nature of each case. The results obtained from this retrospective study may contribute to clinical decision-making by presenting outcomes of chronic and acute cases of equine laminitis over a 5-year period. Whereas acute laminitis could be managed adequately by medical and supportive care in the majority of cases, the treatment failed in most of the animals suffering from chronic laminitis. 57.14% of these animals were euthanized during their hospitalization or within a short period following their discharge from the clinic. Some of these horses and ponies might have benefited from surgical intervention, and deep digital flexor tenotomy or hoof wall resection may save those animals that are unresponsive to other treatment strategies. No adverse effects of acepromazine or heparin during the acute phase were noted in any of the cases. In fact, most animals that received this medical treatment plus hoof casts recovered without progressing to the chronic phase and 80% of all animals with acute laminitis regained their original performance. In addition, those animals that were admitted during or before the onset of the acute phase of laminitis received immediate medical treatment against any underlying diseases. As a result it can be assumed that the faster the underlying diseases, thus the laminitis trigger-factors, are eliminated and the clinical symptoms of laminitis are detected and reacted to, the better are the chances for complete recovery. The most frequent cause of equine laminitis, determined in this study, was disorders of the equine intestinal tract with a share of 34.04%. Frequent monitoring of the hooves of horses and ponies with prolonged and severe intestinal disorders or inflammatory diseases; prophylactic administration of acepromazine and heparin; and preventive cooling of the distal limbs may help to entirely spare these animals and their owners the distress associated with equine laminitis. Even though the overall frequency of equine laminitis was rather low in this study (1.7%), the disease is definitely a very serious medical condition which, if allowed to progress, can quite often have a fatal outcome. Many cases of equine laminitis go undetected for a long period of time until it is too late for the horse or pony to gain a satisfactory degree of recovery and to return to its original performance. Therefore, understanding the numerous risk factors for laminitis and how to prevent or control them, as well as recognizing the symptoms of laminitis are paramount. However, it is equally important to understand the pathomechanisms and the course of the disease in order to create a more targeted and effective treatment plan that can be tailored to individual cases.