Parker, a 5 month old Quarter Horse colt presented to the large animal medicine section of Cornell University Hospital for Animals on 10/01/02 with a 2-week history of serous to purulent nasal discharge, which had recently changed to green discharge with feed material in it. There is no history of strangles on this farm. Endoscopic examination of the nasopharynx showed evidence of dysphagia and a mass ventral to the epiglottis. The appearance and location of the mass were consistent with a subepiglottic cyst. Thoracic ultrasound showed increased pleural echogenicity and fluid, indicating possible aspiration pneumonia. The patient was transferred to the large animal surgery section of the hospital for removal of the subepiglottic cyst. Surgical removal of the cyst was accomplished with the foal in sternal recumbancy and under general anesthesia. An oral approach was utilized, using the endoscope as a guide. The cyst was removed and sent to histopathology, the results of which were consistent with the diagnosis of a subepiglottic cyst. The foal recovered from surgery uneventfully.