In recent years the usefulness of the alpha 2 adrenoceptor agonist drugs has been recognized in equine practice. Several agents have become available and are now licensed for use in a number of countries. The principle actions of all alpha 2 adrenoceptor agonists are similar, in that they produce a reduction in heart rate and alteration of heart rhythm, an initial hypertension followed by a prolonged hypotension, a decrease in the cardiac output and respiratory depression. For clinical purposes, these agents produce sedation and analgesia, they are useful for premedication and markedly potentiate the effects of other sedative/analgesic agents. Differences in receptor specificity between the alpha 2 adrenoceptor agonists results in the distinguishing characteristics of the individual agents, particularly with respect to their duration of action, sedative effect and analgesic properties; their cardiopulmonary effects are however similar, when equipotent sedative doses are administered. When used in combination with other agents, the alpha 2 adrenoceptor agonists all appear to act in a similar manner, with the greatest difference being related to their duration of action.