This case study examined the surgical alleviation of pain in a horse. A tenoscopic approach allowed incision of the carpal sheath and the flexor retinaculum with minimal invasiveness. This procedure may be beneficial to any equine patient with carpal canal pain. Examined here was the case of a 15 year old mixed-breed gelding that presented initially to Cornell University Equine/Farm Animal Hospital in April 2008 for non-weight bearing lameness in the right thoracic limb. Lesions were identified by ultrasonography in the deep digital and superficial digital flexor tendons of that limb. The more severe injury was injected with platelet rich plasma (PRP). When the gelding showed minimal improvement after four months of PRP treatment and rest, the tenoscopic release of the carpal canal was performed. This surgical procedure resulted in an increased soundness and comfort for the horse.