The authors review equine granulocytic ehrlichiosis (EGE) in Italy from 1996 to 2002. In 1996, the first case of EGE has been observed in a horse affected with specific symptomatology (fever, lethargy, anorexia, limb edema, thrombocytopenia, and petechiae). In 1997, a seroepidemiological survey was performed in the province of Rome on 563 animals using IFAT. The authors describe the last case, which occurred on 2002 in a 15-year-old male, bay, half-breed, tick-infested horse. Clinical features included fever, lethargy, limb edema, icterus, leukocytopenia, and thrombocytopenia. Laboratory tests were positive for ELISA and IFAT and several morulae were seen in the cytoplasm of neutrophils in buffy coat smears. The authors think that in Italy the prevalence of EGE is underestimated because of the nonpathognomonic clinical symptoms, the diffusion of specific infected vector, and the nonroutine nature of specific laboratory tests.