Background: Facial swellings are a common presenting sign in horses and can have many causes. Some swellings can be caused by significant disorders such as sinus cysts, sinonasal neoplasia or dental abscessation, which require immediate diagnosis and treatment. However, facial swellings similar to some of these disorders may also be caused by facial suturitis and these may cause great concern to some horse owners.Aim of the article: This article describes the anatomy of the equine facial sutures and explains the known causes and the clinical and ancillary diagnostic findings of equine facial suturitis, so that practitioners can confidently make a diagnosis and advise clients of its usually innocuous nature. Management of cases with suture infections is also described.