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Summary Extracorporeal shockwave therapy (ESWT) has been implemented as a treatment for musculoskeletal injuries in horses. ESWT uses acoustic waves applied to a region of injury, and has been shown to improve lameness, decrease time of healing and improve ultrasonographic appearance of tendon and ligament injuries. However, much of the current literature surrounding the use of ESWT in veterinary medicine is positively biased and most studies have lower levels of evidence‐based experimental design. Randomised clinical trials are needed to determine specific energy settings, dose, frequency and case selection for different anatomical regions, and to investigate long‐term effects of ESWT as well as interactions between ESWT and regenerative biological therapies.

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