Equine endoparasites continue to pose a significant threat to horse health, performance, and productivity worldwide. The most prevalent and pathogenic species—cyathostomins , large Strongyles, Parascaris, Dictyocaulus, Oxyuris, and Gastrophilus—cause a range of clinical and subclinical disorders that impact equine welfare and management. Despite decades of reliance on anthelmintic therapy, the emergence of widespread resistance across multiple drug classes has severely compromised the efficacy of traditional, calendar-based deworming programs. Recent advances in diagnostic technologies, including molecular assays, coproantigen detection, and serological testing, have greatly improved sensitivity and species identification, allowing for more targeted surveillance and treatment. However, the adoption of these tools remains limited by cost, accessibility, and standardization challenges. Sustainable parasite control now emphasizes evidence-based, selective deworming guided by fecal egg counts and resistance monitoring, integrated with sound pasture hygiene, biosecurity, and management practices. Continued research into novel therapeutics, vaccines, and biological control strategies, coupled with stakeholder education and coordinated surveillance, is essential to achieve long-term, sustainable control of equine endoparasites and safeguard the health of equine populations worldwide.