BACKGROUND: Sand enteropathy describes the clinical signs attributed to accumulation of sand in the gastrointestinal tract. Psyllium combined with magnesium sulphate has been recommended for clearing intestinal sand, but this has only been evaluated in one population. The combination of these two agents with paraffin oil has not been investigated. OBJECTIVES: To investigate the effectiveness of paraffin oil, psyllium and magnesium sulphate combined in clearing intestinal sand in horses diagnosed with sand enteropathy. STUDY DESIGN: Retrospective case series. METHODS: Medical records of horses presenting for sand enteropathy that underwent treatment with psyllium, paraffin oil and magnesium sulphate were reviewed. Area of sand was calculated from abdominal radiographs. Treatment was deemed a success if more than 75% of the sand area was cleared. RESULTS: There were 52 horses and 2 donkeys included in the study. Daily treatment with psyllium at 1 g/kg, 6-8 mL/kg of paraffin oil, and magnesium sulphate at 1 g/kg by nasogastric intubation, was successful in clearing intestinal sand accumulation in 81% of equids over a median of 4 days (interquartile range 3-5 days). Success rate was lower in Miniatures Ponies (44%). Complications were common (30%) but were generally mild or self-limiting. MAIN LIMITATIONS: Retrospective nature of study design. Limited to cases that consented to sand clearance treatment. CONCLUSIONS: The combination of psyllium, magnesium sulphate and paraffin oil was effective at clearing intestinal sand in most cases. Miniature Ponies had a poorer response to treatment compared with other breeds and may be at increased risk of treatment failure.