Cyathostomes are now the principle parasitic pathogen of the horse: a remarkable transformation during the last 25 years from virtual obscurity to focus of attention in equine parasitology. This rise to prominence coincides with the marked decrease in prevalence of large strongyle infections as a result of widespread use of modern anthelmintic compounds. On the basis that strongyle-associated diseases continue to commonly occur in the absence of these large strongyle species, clinical attention has turned to the pathogenicity of cyathostomes. Although many horses harbour burdens of tens of thousands of cyathostomes without developing detectable illness, these parasites can result in an inflammatory enteropathy affecting the caecum and colon. Although the principle clinical effect of cyathostomosis is weight loss, affected individuals may exhibit other signs including diarrhoea and/or subcutaneous oedema and/or pyrexia. Clinical cyathostomosis occurs more commonly in young horses in late winter/early spring but there is lifelong susceptibility to cyathostomes and they can cause clinical disease in any age of horse during any season. Animals with cyathostomosis often develop hypoalbuminaemia and/or neutrophilia but there are no clinicopathological features specific for the disease. Experimental infections with cyathostomes have resulted in both clinical and pathological features similar to those of naturally-occuring cyathostomosis cases. From the experimental infection studies, it is evident that cyathostomes are pathogenic at times of both penetration into and emergence from the large intestinal mucosa. An unusual feature of cyathostome biology is the propensity for arrested larval development within the large intestinal mucosa for more than 2 years. From limited studies it appears that this arrested larval development is favoured by: feedback from luminal to mucosal worms; larger size of challenge dose of larvae and trickle (versus single bolus) infection. During arrested larval development cyathostomes have minimal susceptibility to all anthelmintic compounds, thus, limiting the effectiveness of therapeutic and/or control strategies. Although, the relative importance of individual cyathostomes is not known, the development of species-specific DNA methods for identification of cyathostomes provides a means by which the pathogenicity of different species might be established.