A 7 year old Warmblood gelding presented to the Cornell Equine Hospital in November of 2012 for acute onset of colic of several hours' duration. At admission, the patient was quiet but appeared painful, tachypneic, and tachycardic with pale mucous membranes. The pain was refractory to alpha-2 agonists and butorphanol. Physical examination revealed absence of gut sounds in all four quadrants. Ultrasound and rectal examination showed multiple dilated and amotile loops of small intestine. The patient was brought to surgery for an exploratory celiotomy. At surgery, approximately 40 feet of small intestine were incarcerated through the epiploic foramen. After careful extraction, a 22-foot-long segment of the incarcerated portion appeared devitalized and was subsequently resected. Since the patient's large colon was impacted with a significant amount of fecal material, an enterotomy was performed and the colonic lumen was evacuated. The patient remained in the hospital for 11 days after his surgery, during which time he was treated with antibiotics, anti-endotoxic agents, plasma, gastroprotectants, and prokinetic medications. He steadily improved and was discharged. He re-presented to Cornell 5 days later with signs of colic, and was discharged after six days of medical management. This report will discuss the progression of this particular case as well as general strategies for managing colic resulting in epiploic foramen entrapmetn of small intestine.