Equine sarcoidosis seems to be an emerging problem. As more horses are referred for dermatologic disease, equine sarcoidosis should be considered in any case of exfoliative and/or nodular skin disease with or without systemic involvement, including generalized granulomatous disease affecting most internal organs. Multiple breeds are affected with mares being predisposed. Affected horses are typically 3 years or older. The prognosis for generalized granulomatous disease is generally poor, whereas the prognosis for the localized cutaneous form is favorable but may require lifelong treatment.