The entropy stabilized oxide Mg0.2Co0.2Ni0.2Cu0.2Zn0.2O exhibits antiferromagnetic order and magnetic excitations, as revealed by recent neutron scattering experiments. This observation raises the question of the nature of spin-wave excitations in such disordered systems. Here, we investigate theoretically the magnetic ground state and the spin-wave excitations using linear spin-wave theory in combination with the supercell approximation to take into account the extreme disorder in this magnetic system. We find that the experimentally observed antiferromagnetic structure can be stabilized by a rhombohedral distortion together with large second-nearest-neighbor interactions. Our calculations show that the spin-wave spectrum consists of a well-defined low energy coherent spectrum in the background of an incoherent continuum that extends to higher energies.