BackgroundThe potential for an exotic disease incursion is a significant concern for the United Kingdom (UK) equine industry. Horse owners’ perceptions of, and attitudes towards, exotic diseases can influence decisions to adopt disease preparedness strategies. The objectives of this study were to describe horse owners’ 1) perceptions of the term ‘exotic disease’, and 2) attitudes towards their risk of being affected by an exotic disease. In order to address these objectives, qualitative content analysis was undertaken on data collected using two open-ended survey questions.ResultsHorse owners (n = 423) perceived exotic diseases as 1) belonging somewhere else, and 2) a dangerous threat to their horse(s). The term ‘exotic’ was associated with being foreign, non-native, and out-of-place in the UK. Attitudes towards exotic disease risk were summarised into four categories: 1) responsible horse owners prevent disease, 2) horse owners need support to stop disease spread, 3) risk depends on proximity to the ‘risky’ horse, and 4) some risk is inevitable. A ‘responsible’ owner was aware of health hazards and took actions to protect their horse from disease. Reliance on others, including stakeholders, to uphold disease prevention in the community led to feeling vulnerable to disease threats. When evaluating risk, horse owners considered which horses were the ‘riskiest’ to their horse’s health (horses that travelled, participated in competitions, or were simply unfamiliar) and avoided situations where they could interact. Despite undertaking disease prevention measures, the perceived uncontrollable nature of exotic diseases led some owners to feel an incursion was inevitable.ConclusionsWithout accounting for horse owners’ perceptions of, and attitudes towards, exotic diseases, recommendations to increase preparedness may be ineffective. Improved communication among stakeholders in the industry may assist in clarifying expectations for exotic disease-specific prevention measures. A collaborative approach among horse owners and stakeholders is recommended to improve disease preparedness within the industry.