Equine colic remains one of the most common and potentially life-threatening conditions in horses, with dietary factors playing a significant role in its onset and prevention. This comprehensive review examines the dietary risk factors associated with colic, including abrupt feed changes, low forage intake, high concentrate diets, and inadequate water consumption. It also explores the pathophysiological mechanisms linking diet to various forms of colic, such as impaction, gas accumulation, and intestinal displacement. Management strategies—ranging from feeding practices and nutritional planning to the use of supplements and probiotics—are critically evaluated for their effectiveness in reducing colic incidence. By integrating current research and practical recommendations, this review aims to guide veterinarians, equine nutritionists, and horse owners in implementing dietary protocols that support gastrointestinal health and reduce the risk of colic in equine populations.