Inflammatory airway disease, recurrent airway obstruction and summer pasture associated obstructive pulmonary disease are chronic inflammatory disorders of the equine lower airway. They are characterized by chronic bronchitis, an increase in respiratory resistance and an increase in the number of neutrophils in the bronchoalveolar lavage fluid. Besides the conventional treatment with bronchodilators and anti-inflammatory agents, acupuncture (AC) and electro-acupuncture (EA) can provide a safe and effective alternative therapy that possesses little or no negative side effects. Possible therapeutic mechanisms of AC and EA for chronic inflammatory disorders of the equine lower airway are proposed based on research in other species. These therapeutic mechanisms include an increase in the mucocilliary action of the airway epithelium, reduction in airway and pulmonary tissue inflammation, activation of cholinergic anti-inflammatory responses, alteration of the immune response, modulation of the autonomic nervous system and alteration in the peripheral sensory input from the inflamed pulmonary tissue.