Gastric impaction is an uncommon cause of colic in horses. A 19 -year -old Paint gelding presented to the Cornell University Equine Hospital for an 8-hour history of mild colic that was non-responsive to analgesics. On presentation, the horse did not display signs of colic. Physical examination and point of care blood work supported mild dehydration. No significant findings were seen on abdominal ultrasound, or found via manual rectal palpation; nasogastric intubation was not performed. After being maintained on intravenous isotonic fluids and held off feed overnight, the patient underwent gastroscopy. A large amount of fibrous feed was visualized in the stomach upon entry through the cardia, indicative of a gastric impaction. The incidental finding of fourth branchial arch defect was also noted during endoscopy. Gastric lavage was performed as well as administration of 2 L diet cola via nasogastric intubation. The patient was maintained on fluids, omeprazole and sucralfate, and within 24 hours, his gastric impaction resolved. Upon follow-up gastroscopy, gastric ulcers were diagnosed along the lesser curvature of the stomach, and pylorus, necessitating the continuation of omeprazole and sucralfate treatments. The patient was discharged on omeprazole and sucralfate and a recheck examination was recommended in one month's time, for re-evaluation of the gastric ulcers.