Stifle disease in horses presents a significant diagnostic challenge due to the complexity of the joint and the subtlety of clinical signs. Traditional diagnostic methods, while valuable, often lack sensitivity for early or low-grade conditions. Traditional Chinese veterinary medicine (TCVM) offers complementary diagnostic tools based on the assessment of acupoint sensitivity through palpation. This diagnostic technique particularly relies on identification of an important reactive site, the point suggestive of stifle disease (PSSD), and a set of key associated Meridian acupoints, which include Bladder-20, Bladder-21, Gallbladder-27, Gallbladder-dorsal tuber coxae (IVAS acupoint), and Spleen-13. This article summarizes clinical evidence supporting acupuncture diagnosis for equine stifle disease and presents practical treatment strategies. Among the therapeutic approaches, particular emphasis is given to the Balance Method, especially the use of acupoints located around the eyes for treating stifle conditions. By integrating TCVM diagnostic palpation with conventional imaging modalities, equine practitioners can improve early detection and treatment outcomes. Clinical pearls and practical tips are provided to facilitate incorporation of a TCVM approach to stifle disease diagnosis in equine practice. Further research is warranted to validate and optimize these techniques for broader clinical application.