Horse related injuries include falling from a horse, being stepped on by a horse, kicks, or bites. Bites are rare and often associated with fatalities. We present a case of a 41-year-old healthy female who suffered a complete amputation of her right nipple and abrasion of the areola following a horse bite. We managed the nipple injury as a full-thickness skin graft, similar to that of a compromised nipple in a reduction mammaplasty or mastopexy case. Barring a lack of projection and minor hypopigmentation, the nipple had normal sensation with no scar contracture. Overall, the patient was happy with her final outcome. With a healthy, minimally contaminated wound bed, and lack of poor wound healing risk factors, we believe that treating a nipple amputation as a full thickness skin graft in the emergency setting results in aesthetic outcomes, sensation, and patient satisfaction comparable if not superior to other means of nipple reconstruction in adults.