In the horse, proximal sesamoidean osteomyelitis is an uncommon condit
ion that can cause severe lameness. In this case, aggressive surgical
and medical therapy was necessary to cause significant improvement in
lameness in a 6-year-old American Quarter Horse. This case report repr
esents the progression of osteomyelitis into the first reported proxim
al sesamoidean sequestrum of the horse and its surgical treatment with
resulting favorable outcome.