Cross sectional study was done from November 2008 to April 2009 with the objective to identify the major health and management problems of cart horses in and around Debre Zeit town, central Ethiopia. Animal based, retrospective data analysis of clinic cases presented to the society for protection animal abroad (SPANA) veterinary clinic from 2007-2008 and owners interviews used to collect data. A total of 435 randomly selected cart horses were examined and 100 owners or users were interviewed. According to cases brought to veterinary clinic, wound and abscessation recorded highest cases (39.3%), followed by infectious disease (25.28%), respiratory disorder (12.07%), ocular disorder (5.85%), alimentary disorder (4.87%) and dermatological disorder (3.8%). Internal parasite such as Strongyles, Parascaris equorum and Gastrodiscus species were found in proportion of 61.1%, 29.2% and 9.7%. Compared to the retrospective data analysis, wounds, ocular problems. infectious disease and respiratory problems are decreasing in occurrence while alimentary system disorders such as colic and musculoskeletal disorders increased. Among the 100 respondents interviewed, 69% of cart horse owners interviewed responded that they feed their horses with concentrate, 22% feed with crop residues and concentrate, 4% feed with only crop residue and 5% graze them on pasture and supplementing with hay or straw at night. All respondents of the questionnaire survey indicated that epizootic lymphangitis and helminthosis were the major health problems of their horses followed by wounds. Management and welfare understanding of carthorses owners were found to be un satisfactory. Therefore, equine health and management awareness enhancement education to carthorse owners, development of legislation for the control of abuse of working animals and socio-economic impact of major health problem of equines are recommended.