Temporohyoid osteoarthropathy is a disorder of horses affecting the bones of the temporohyoid joint (stylohyoid and petrous temporal bones). Bony proliferation at the articulation of the stylohyoid bone with the petrous temporal bone can result from multiple etiologies including otitis media/interna, gutteral pouch infection or as a primary degenerative joint disease. Eventually, ankylosis of the temporohyoid joint occurs, predisposing the petrous temporal bone to fracture. Subsequent fracture can result in acute onset of neurological signs ranging from facial and/or vestibulocochlear deficits to grand mal seizure and death. This paper reports on the clinical signs, diagnostic test results, treatments and outcomes of a thoroughbred gelding with facial nerve paralysis secondary to temporohyoid osteoarthropathy.