The annular ligament constriction is characterized by a disproportion between the available space and the contents within the fetlock tunnel. The main symptoms are a persisting lameness, distention of the tendon sheath, a typical "notch" when the fetlock is viewed from the side and a hyperflexion pain in the fetlock. The surgical treatment consists of the transection of the fetlock annular ligament. The conservative management can be considered as a independent therapy or as a preparation for a subsequent desmotomy. The medical records of 75 horses suffering from fetlock tunnel syndrome presented at the Veterinary Surgery Clinic of the University of Zurich were studied. 39 horses with 41 affected limbs were reexamined clinically and ultrasonographically. 70% of the surgical cases and 82% of the conservatively treated cases were judged to be sound. Altogether it can be said that the surgical case group had a success rate of 62% while the conservatively treated group showed a success rate of 58%.