The importance of adequate pain management in horses has gained increased clinical attention over the last decade or so, and many drugs and administration techniques have been investigated for the purpose of improving equine pain management. Caudal epidural anaesthesia and analgesia (CEAA) has the potential to be one of the most efficient techniques for management of moderate to severe pain of the pelvic limbs, the caudal part of the body and even the thoracic limbs. The epidural administration of many different drugs has been studied and clinically applied, most of them with good efficacy and minimal side-effects. In order to guide the clinician on when and how to perform CEAA in horses, this 2-part review provides a detailed review of the efficacy, safety, indications and techniques. Part 1 focuses on the efficacy and safety of epidurally administered drugs and Part 2 considers indications and contraindications, and provides a practical description on how to perform the epidural procedure.