Encephalitozoon cuniculi is often a suspected cause of head tilt in rabbits. However, a definitive diagnosis is difficult to obtain. This presentation will discuss the pathophysiology of head tilt in rabbits, particularly relating to E. cuniculi and other causes such as otitis media/interna. There will also be a discussion of published literature on the topic to help attendees decide if E. cuniculi should be high on their differential diagnosis list when managing a rabbit with a head tilt.