The aim of this study was to evaluate systematically the quality of equine veterinary top sports medicine in The Netherlands and the degree to which the expectations in the field are met. Focus was on structure, process and outcome of care. The structure of care is generally satisfactory but there is insufficient transfer of applicable scientific knowledge to the equine community and a lack of regular checks by team vets. The process of care is hampered by the failure in communication between the veterinary and paraveterinary members of a team. For continuation of the excellent international results of Dutch riders and drivers a more collaborative approach, abandoning the often secretive character of equine medicine in relation to sport horses, is necessary.