Equine placentilis is an important disease that affects present and future mare reproduction, with significant economic impact. Though placentitis is a fairly common diagnosis, no established treatment strategies exist and outcome varies widely. In this case, a 14 year old multiparous Hanoverian mare that foaled three limes previously without complication presented for precocious udder development with milk leakage. Other physical examination findings were consistent with a diagnosis of placentitis, and empirical therapies were instituted to maintain pregnancy. Despite close monitoring and continuation of well accepted therapeutic strategies, the patient foaled spontaneously al 312 gestation, and the foal was born without heartbeat or respiration. The mare had retained fetal membranes in the non-gravid horn, which led to metrilis and endotoxemia, which in tum led to laminitis. She also developed a right dorsal colon displacement. With aggressive supportive care, the mare was discharged 1.5 weeks after foaling.