Equine protozoal myeloencephalitis (EPM) is an important neurologic disease of horses caused primarily by Sarcocystis neurona and, less commonly, Neospora hughesi. Definitive diagnosis and successful treatment remain challenging, and clinical signs may vary widely depending on the location and severity of central nervous system involvement. From the perspective of traditional Chinese veterinary medicine (TCVM), EPM may be associated with Zheng Qi Deficiency, allowing invasion by pathogenic factors, creating Qi and Blood Stagnation within the central nervous system. Stressful events may further contribute to Liver Qi Stagnation, disruption of Spleen Qi function, and progression of Deficiency and Stagnation patterns. This paper reviews the TCVM pattern diagnosis and treatment of EPM, including acupuncture, aqua-acupuncture, pneumo-acupuncture, and Chinese herbal medicine. The use of TCVM as part of an integrative approach with conventional pharmaceutical therapy is discussed, along with its potential role in supporting recovery and reducing relapse. A case report is included to illustrate the clinical application of TCVM principles in the management of EPM.