Many myopathies in horses can be managed by exercise regimes and dietary modifications. This includes modifying the amount of nonstructural carbohydrate, fat, amino acids, vitamin E, and selenium based on the horse's specific myopathy, metabolic status, exercise program, and optimal body weight. Because dietary recommendations differ substantially between myopathies, it is imperative to establish a specific diagnosis. A nutritionist will help practitioners select from the myriad of offered products to ensure a balanced diet. This article provides detailed recommendations for a variety of myopathies affecting performance horses.