Infection with Streptococcus equi, which forms abscesses in the lymph nodes of the head and neck in horses, is endemic in almost all countries around the world. The identification and isolation of horses with fever, an early sign of disease, is critical to minimising the number of horses affected and the severity of an outbreak, while the identification and treatment of persistently infected ‘carrier’ horses can reduce the risk of recurrent outbreaks and transmission between equine populations. Rapid diagnostic testing plays a key role in the identification of infected horses, which can then be isolated before the development of acute disease or treated to clear persistent infection. Vaccination can also be used to reduce the number of horses that become infected and the severity of their ensuing disease. This review describes the tools available to veterinarians and the journey towards the development and launch of a multi-component fusion protein vaccine that does not trigger positive diagnoses with any of the available diagnostic tests for strangles. The use of vaccination, alongside conventional methods of biosecurity and diagnostic testing, has the potential to unsaddle S. equi, reducing the number of strangles outbreaks and enhancing the health of horses.