Chronic and acute pain is an evolving topic in veterinary medicine and is often difficult to identify and treat effectively. The primary focus of this seminar is to discuss the new advances in understanding the physiology behind different states of pain (i.e. neuropathic, orofacial, oncologic, and acute and chronic) in both small and large animals (equine). These developments have provided a new strategy in approaching this medical condition with specific target-controlled therapies that can be utilized by all veterinary practitioners. It also discusses the latest in acute and chronic pain assessment in small animal patients and horses and current controversial topics in pain management. Updates on providing effective equine standing sedation, general anesthesia and analgesia are also discussed, with particular focus on equine recovery following anesthesia.