This talk is designed to equip equine veterinarians with a practical, systematic approach to the diagnosis and management of common skin masses in horses. Skin lumps and bumps are frequent challenges in general equine practice, and their identification and appropriate diagnosis impacts outcome. Today there are many treatment options available and new ones seem to be hitting the marker every year making choices difficult. We will discuss traditional as well as newer treatment options so that informed decisions can be made. Attendees will be guided through a diagnostic approach emphasizing how to choose the most appropriate diagnostic tool in different field settings. In addition, the presentation will cover updated treatment options for these conditions, ranging from surgical excision and cryotherapy to newer pharmacological approaches, including topical and injectable treatments. Attendees will learn about the advantages, limitations, and expected outcomes for each treatment method, allowing them to tailor recommendations to the needs of their patients and clients. This talk will also address how to communicate with clients about prognosis, cost considerations, and the likely response to different therapies, helping practitioners provide realistic expectations to horse owners. By the end of the session, participants will feel more confident in their ability to diagnose, manage, and communicate about common skin lumps and bumps in horses, leading to improved care and client satisfaction.