This paper reviews current developments in equine osteochondrosis complex and the clinical syndromes associated with it. Although the primary lesion has been defined as a failure of endochondral ossification, its definitive cause is unknown and appears to involve heredity, growth rate, nutrition, mineral imbalance, endocrinological dysfunction and biomechanical trauma. Despite the international importance of osteochondrosis in horses, surprisingly few controlled investigations have been performed on its pathogenesis. The studies that have been conducted suggest that local effects on differentiating growth cartilage are the key to a more complete understanding of the problem. Gaps in the current knowledge include in-depth understanding of the life cycle of chondrocytes in growth cartilage, the process of mineralisation and the use of a standard experimental model for the induction of osteochondrosis. The ultimate goal of osteochondrosis research must be to prevent or reduce the incidence of the condition in horses.