Pleuropneumonia is a difficult and expensive disease to treat that follows several predisposing events commonly experienced by equine athletes. It is most commonly regarded as a medical disease, but in some severe or chronic cases, open throacotomy has been an effective treatment. In this case, the horse presented following long distance transportation with severe signs consistent with pleuropneumonia. Medical therapy was unsuccessful and an open thoracotomy was performed. The pleural space was subsequently debrided and flushed daily. Initially he responded well, with the exception of an unresolving low grade fever. Approximately one month following surgery, he developed progressive dysphasia and eventually aspiration pneumonia in the ventilating lung, and was euthanized due to respiratory distress. Necropsy findings were inconclusive as to the origin of the dysphasia.