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BACKGROUND Cervical spinal nerve insult can be a sequel of osteoarthropathy in horses due to enlargement of the articular processes (AP). OBJECTIVES To describe the percutaneous endoscopic cervical foraminotomy procedure in horses. STUDY DESIGN Ex vivo experimental study and clinical case report. METHODS The technique was performed in 3 equine cadavers and in 2 clinical cases with history of forelimb lameness located in the caudal cervical region. Briefly, the horse was positioned in lateral recumbency, with the affected AP joint uppermost. Under fluoroscopic guidance, the endoscopic instruments (Ø 6.9mm, length 207mm, 25° angle of vision) were positioned at the dorsal bony margin of the intervertebral foramen (IVF). The bone was freed from soft tissues and removed using diamond various burrs, hence widening the intervertebral foramen. The bone drilling was continued until the medial cortical surface of the caudal AP was removed. Thereafter, the endoscope was removed and the skin portal was closed. RESULTS The average of operation time in clinical cases was 98±24 min. The horses recovered smoothly from the operation. At 12-month follow-up, the clinical signs had resolved completely without recurrence. MAIN LIMITATION Small number of clinical cases and absence of post mortem examination or histopathology performed in the cadaver study to assess possible iatrogenic injuries. CONCLUSION Cervical spinal nerve decompression via minimal invasive foraminotomy is feasible in horses. More research is required before this procedure can be recommended in clinical cases. This article is protected by copyright. All rights reserved.