Summary The rapid development of software and technology now allows a large amount of diagnostic information to be obtained from a computed tomographic examination. This imaging technique can also be usefully applied to the horse, given appropriate premises and a custom built table for accurate positioning. Computed tomography of the skull has considerable advantages over other techniques, as structures are viewed without superimposition. Fifteen cases are used to demonstrate how through high image quality (precise detail, reduction in artefacts) and objective measurement of density, various pathological changes can be analysed and exact diagnoses achieved. In particular, short measurement and examination times allow preoperative imaging under general anaesthesia giving significant information to assist subsequent surgery.