This case study is that of a three year old Standardbred stallion. He presented to Cornell with a history of chronic right hind limb lameness. Examinations by other veterinarians had resulted in conflicting diagnoses as to the origin of the lameness. At Cornell, a lameness evaluation was conducted, localizing the lameness to below the fetlock. Radiography, ultrasound evaluation and nuclear scintigraphy were conducted, however the exact cause of the lameness could not be determined. The horse was sent to another facility for MRI evaluation which identified tendon adhesions between the deep digital flexor tendon and the tendon sheath at the level of P1. The stallion returned to Cornell where the adhesions were removed via tenoscopy. This seminar focuses on lameness examination of the horse as well as imaging techniques used to aid in the diagnosis of equine lameness. The tenoscopic surgical technique used in this case will also be discussed.