Streptococcus equi subsp. equi (S. equi) is a frequently encountered pathogen in equine practice. S. equi causes infection of the upper airways of horses, a condition known as strangles. Strangles is a highly contagious disease and may be economically devastating as well. Difficulties in the eradication of the disease using vaccines and medical treatments make hygienic measures crucial in order to limit transmission of the pathogen during outbreaks. This review aims to elucidate the challenges in handling an outbreak of strangles as well as develop a basic plan on how such an outbreak is handled in a hygienically optimal fashion. The results of this review suggest a longer environmental survival time of S. equi than previously assumed and support the importance of modification of surfaces for proper disinfection with appropriate disinfectants. Furthermore, the efficiency of using a colour-coding system in dividing healthy, exposed and clinically affected horses is discussed. Individual temperature monitoring twice daily is recommended for the identification of diseased horses before they pose a contagious risk. Additionally, changing clothes between visiting different stable units is likewise recommended, to minimise transmission of disease. In conclusion, veterinarians, personnel and horse owners at equestrian centres need to be aware of the importance of isolation, monitoring and dividing the site into zones according to the risk of infection. Finally, it can be concluded that regardless of size, practical biosecurity measures can be implemented within all equine facilities.