Transoral axial division was performed, using endoscopic guidance, in 20 horses with epiglottic entrapment. Mean age of affected horses was 3 years (range, 2 to 5 years), and there were 18 Standardbreds and 2 Thoroughbreds. Standardbreds and female horses were significantly overrepresented when compared with a reference population. Upper respiratory noise prompted endoscopic examination before surgery in 16 horses, but noise was not heard in 4 horses. Ten horses had entrapment by thin tissue without ulceration, 6 horses had entrapment by thin tissue with small, partial-thickness ulceration, 3 horses had entrapment by moderately thick tissue with large, partial-thickness ulceration, and 1 horse had entrapment with thick tissue and severe ulceration. After surgery, horses received anti-inflammatory medication and box stall rest with hand walking for 7 days. All horses returned to race training on day 7 after surgery and returned to their previous level of racing or training. Epiglottic entrapment recurred in 2 horses (10%), and dorsal displacement of the palate developed in 2 horses after surgery. Relationship of epiglottic entrapment and dorsal displacement of the palate to epiglottic hypoplasia was not apparent. Transoral axial division under endoscopic guidance appeared to be a useful, safe, and economic alternative to currently available methods for management of epiglottic entrapment in horses. Horses with entrapment by thick and ulcerated tissue may be best managed by surgical resection of entrapping tissue.