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• Improving equine anesthetic induction enhances general anesthesia. • Protocol and measures can help to reduce risk and improve outcome. • This review summarizes literature findings from the past 50 years. Horses are the most challenging of the common companion animals to anesthetize. Induction of anesthesia in the horse is complicated by the fact that it is accompanied by a transition from a conscious standing position to uncconconscious recumbency. The purpose of this article is to review the literature on induction of anesthesia with a focus on the behavioral and physiologic/pharmacodynamic responses and the actions and interactions of the drugs administered to induce anesthesia in the healthy adult horse with the goal of increasing consistency and predictability. [ABSTRACT FROM AUTHOR]