Equids are hosts to dozens of species of internal parasites that infect no other domestic animals. Virtually all horses, especially those exposed to pasture, experience some level of parasitism continuously. Despite pathologic evidence of parasitic damage in various organs and tissues, few parasitisms are manifested systemically in well-managed horses. Contrary to conventional wisdom, only three common parasitisms of horses are likely to be manifested as colic: Strongylus vulgaris, Parascaris equorum, and Anoplocephala perfoliata. This article discusses the life cycles, pathophysiology, manifestations and clinical findings, treatment, and management of these three common parasitisms. It also discusses related aspects of several other parasitisms that are unlikely to cause colic.