A twenty-eight year old Arabian gelding presented for evaluation of a penile and preputial mass. The gelding had a history or recurrent penile and preputial squamous cell carcinoma that was first diagnosed October 1998. Since that time the horse had undergone several treatments including topical chemotherapy with 5-fluorouracil, resection of the penis and prepuce via reefing procedures, partial penile amputation, and several mass resections. Historical problems also included Cushing's disease, left jugular vein thrombosis, and recurrent airway obstruction (RAO). Physical examination revealed a bright, alert, and responsive horse with a BCS of 2.5 out of 5 and a long, thick, curly hair coat. Harsh lung sounds with inspiratory and expiratory wheezes and wet, harsh tracheal sounds were heard on auscultation. There was severe swelling of the prepuce with an 8-10 cm ulcerated mass located within the prepuce. Bloodwork showed a normocytic, normochromic anemia with a leukopenia, band neutrophilia and lymphopenia. The horse underwent surgery which included en bloc phallectomy, left inguinal lymph node resection and a scrotal urethrostomy. He recovered well and was discharged to his owners six days later.