Luxation of the coxofemoral joint is relatively rare in horses because of the strong ligamentous support provided to the joint by the round ligament and the accessory femoral ligament, as well as the fibrocartilaginous lip that surrounds the acetabulum. In horses, this injury is usually secondary to trauma. Luxations are much more common in small ponies, such as Shetland ponies, in which luxation of the coxofemoral joint has been frequently described secondary to upward fixation of the patella. Fracture of the dorsal acetabular rim may accompany the dislocation. Luxations are usually accompanied by a characteristic alteration in limb appearance. Luxations of the coxofemoral joint are best managed by closed reduction under general anesthesia, although this is likely to be successful only if the reduction is performed soon after the injury. It can be difficult to maintain the reduction in place through recovery from general anesthesia, and although the use of surgical techniques or Ehmer slings has been advocated, no single technique has been shown to be successful. The prognosis for return to athletic function after coxofemoral luxation is very guarded. In small ponies, closed reduction has allowed animals to become comfortable pasture animals.