Eleven horses with unilateral distension of the sheath are reported with emphasis on the use of plain and contrast radiography in diagnosis. Six had associated bony abnormalities of the sustentaculum tali, and two of these showed destructive or mixed destructive and proliferative lesions resulting from osteomyelitis. One horse had a fracture of the sustentaculum. In three horses proliferative changes were found. Bony changes were best demonstrated on a dorsomedial-plantarolateral oblique view. Contrast radiography of the tarsal sheath was performed in five cases without, and two horses with, associated bony lesions. In five cases ballooning with or without folding of the proximal aspect of the sheath was demonstrated. Additional band-like filling defects (two cases), triangular filling defect (one case), nodular intra-tendovaginal masses (two cases), or an extra-tendovaginal mass (one case) were noticed. The remaining two horses showed a semicircular collar shape dilation of the proximal aspect of the sheath. Contrast radiography appeared to be a helpful tool for the examination of tarsal sheath lesions. Two horses with associated bony changes were destroyed immediately after diagnosis, one failed to recover following surgical intervention and in three horses the outcome was unsatisfactory after conservative treatment. Three horses without associated bony lesions recovered completely after conservative treatment. One was operated on subsequently; the results are promising but the outcome of this case is not yet known. One was sold shortly after diagnosis and lost to follow up.