A good working knowledge of regional and clinical anatomy of equine gastrointestinal tract and associated intra-abdominal organs is essential for the equine practitioners who dealing with the horses that exhibit the sign of acute abdominal pain (colic). Gaining anatomical knowledge of equine gastrointestinal tract provides a key to the early diagnosis and treatment of equine abdominal diseases. In this chapter, various surgical approaches (laparotomy) and regional anatomy of stomach and intestine of horse are discussed for diagnosis and surgical correction of GI tract disorders. The equine stomach has peculiar anatomic arrangement of cardia that forms a functional one way valve that permits movement of gas and fluid into the stomach but not out of it that is one of the key factors of digestive tract problems. Equine intestine has anatomically predisposed to obstruction due to its sudden change in the diameter or size of lumen. This chapter emphasized the changes in the lumen size of intestine, anatomical position or relationship among other organs, exploration and land marks in identification of various parts of intestine, abdominal wall etc. which are important to veterinarian/surgeons who dealt with colic and gastrointestinal tract diseases.