Anthelmintic resistance is a growing global problem in the equine sector. Only three classes of anthelmintics are authorised for use against equine nematodes, and resistance to all of them has been reported in the UK. Resistance to praziquantel, which is effective against equine tapeworms, has also been reported. The use of anthelmintics therefore needs to be restricted, and adoption of diagnostic-led targeted treatment regimens is essential to protect efficacy and slow further development of resistance. This article discusses current recommendations regarding helminth treatment and control in horses and summarises Controlling ANTiparasitic resistance in Equines Responsibly and British Equine Veterinary Association guidelines published in 2024.