Necropsy of a 19-year-old Belgian saddle-horse gelding (stabled in a farm in Italy) with a history of a multifocal neurological syndrome and a recurrent epistaxis revealed a progressive ethmoid haematoma, a moderate interstitial nephritis, and a pituitary gland microadenoma. Histological examination of the brain revealed a disseminated meningoencephalitis; nematodes with a rhabditiform oesophagus were also present. The histopathological features of the lesions and the morphology of the parasites were consistent with Halicephalobus (Micronema) deletrix infection. This is thought to be the first case of H. deletrix encephalitis in Italy, and it is suggested that H. deletrix should be considered in the differential diagnosis of equine encephalopathies in this country.