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While our understanding of pituitary pars intermedia dysfunction (PPID) remains limited a great deal of progress has been made recently in diagnosis and management of the condition. The disease should be considered in all but the youngest horses with laminitis and endocrine testing should be performed. Measurement of adrenocorticotropic hormone (ACTH) and insulin concentrations are recommended and a follow-up thyrotropin-releasing hormone (TRH) stimulation test should be performed if borderline ACTH results are obtained. Pergolide is the only licensed treatment for the condition and the only treatment that is likely to be effective. Horses that are being treated should be monitored clinically and endocrinologically every few months as response to treatment between individuals is variable. The importance of appropriate nutrition and good preventive medicine in horses with PPID cannot be overemphasised.