Horses lie down and roll for a variety of reasons. The key is distinguishing between "normal" (pleasure rolling) and rolling that results from pain or illness. Generally, horses lie down and roll for pleasure and to scratch an itch. They tend to roll after tack is removed to ease irritation from drying sweat, and they often roll after a bath. Many horses roll to gain temporary relief from flies and other insects.

Horses also roll, sometimes violently and repeatedly, when they are suffering from abdominal pain (colic). A horse that is covered in shavings or other bedding has been down and has probably rolled.

There is a great fear among horse people that if their horse rolls, it will twist the intestine. This may be true but we also do know that horses can twist their large colon without rolling. If the horse lies quietly, let them lie. If they consistently roll, get them up and walk them. Use caution when handling horses in severe colic pain. They can drop quickly and injure their handlers.