Laminitis - inflammation of the sensitive laminae within the hoof causing severe pain and potential rotation of the pedal bone - is one of the most painful and welfare-significant conditions in horses and ponies. Clinical signs include characteristic leaning back posture, heat in hooves, reluctance to move, and a bounding digital pulse. Severe cases result in pedal bone rotation or sinking, causing permanent lameness and necessitating euthanasia. Laminitis causes include excessive carbohydrate intake (pasture sugars, grain), endocrine disease (Equine Metabolic Syndrome, PPID/Cushings), and systemic illness. Welfare-positive management involves dietary restriction through track systems or restricted grazing, appropriate soaking or specialist shoeing, and pain management using NSAIDs and analgesics. Prevention focuses on body weight management, gradual pasture introduction in spring, and endocrine testing in at-risk ponies. Research confirms that hoof boots with deep-fill support material significantly reduce pain and improve outcomes in acute cases.