Background: Neuro-ophthalmic disorders, although still uncommon, are being reported more often in horses. Cases can present with a wide range of clinical signs, from chronic, non-healing corneal ulcers to behavioural changes due to visual impairment. Achieving the correct diagnosis is not always easy. Using a systematic approach to examine horses with suspected neuro-ophthalmic disorders will help the clinician to achieve a neuroanatomic diagnosis and a list of differential diagnoses. The diagnostic tests are always planned based on this list of differentials and the treatment is targeted to the final or most likely diagnosis. Understanding the neuro-ophthalmic anatomy is mandatory to achieve the correct neurolocalisation and plan the appropriate diagnostic modalities.Aim of the article: This article reviews the most important neuro-ophthalmic pathways to interpret the clinical signs and underlying causes seen in this field.