The equine sarcoid is the most common skin neoplasia in the horse. It has a worldwide distribution and can also affect other equids such as donkeys, zebras, and mules. All breeds can develop the disease at any age, with no sex predilection, although geldings seem to be overrepresented. This fibroblastic neoplasm has several clinical presentations and microscopic features and has a nonmetastatic behavior but can be severely locally invasive. In many cases, multiple sarcoids may develop simultaneously or sequentially during their life and spontaneous remission is rarely reported. The etiology is multifactorial and involves bovine papillomaviruses, genetic, and environmental factors. Treatment options include different modalities depending on multiple factors: lesion type, location and extent, individual patient, facilities, owner, and financial issues.