The following is a case report of a 4-year-old Thoroughbred racehorse who presented to the Cornell University Equine Hospital on 9/13/04. The presenting complaint was exercise intolerance strongly associated with a dramatic upper respiratory noise. The history also included suspicion of a dorsal displacement of the soft palate. Physical exam revealed no significant abnormalities. Standing endoscopy revealed a grade 3 laryngeal hemiplegia. Treadmill examination revealed that full abduction of the arytenoids was possible, but became incomplete as exercise progressed. A dorsally displaced soft palate was also observed, but it was easily replaced. Because of the dual disorders, and the relatively ease with which the soft palate was replaceable, correction of the laryngeal hemiplegia was decided upon. There are many different options for the correction of laryngeal hemiplegia. In this case, a laryngoplasty and a ventriculectomy were performed. Prognosis for return to successful racing is good to guarded, considering the many complications which can occur postoperatively.