Horses with behavioral abnormalities may injure themselves or their handlers, display aggression towards humans and other horses and disrupt the human-horse relationship. These behaviors are precipitated by stressful events, such as frightening experiences, changes in herd dynamics or training, traveling and showing experienced frequently by equine athletes. Diagnosis and treatment of equine behavior is challenging with conventional medicine. Traditional Chinese veterinary medicine (TCVM) offers a unique treatment perspective for unwanted equine behavior. In TCVM, equine behavioral abnormalities are commonly due to Shen Disturbance, which may be caused by six underlying TCVM pattern diagnoses: Liver Qi Stagnation, Phlegm Fire Flaring Upward, Phlegm Misting the Mind, Heart Yin Deficiency with False Heat, Heart Yin/ Blood Deficiency and Heart Qi Deficiency. Each pattern has distinguishing features on the TCVM exam which aides in accurate pattern diagnosis which is critical for effective treatment selection of acupuncture points and Chinese herbal medicine. The use of TCVM treatment utilizing acupuncture and Chinese herbal medicine can be an effective approach either as a sole treatment for mild behavior cases or as part of a comprehensive program to resolve unwanted equine behavior and safeguard the wellbeing of horses and their handlers.