To compare clinical data of horses with entrapment of the small intestine by the gastrosplenic ligament (ESIGL) to clinical data of horses with other strangulating small intestinal lesions. Retrospective case series. Medical records (January 2001-December 2011) of horses that had exploratory celiotomy for acute abdominal pain associated with strangulating small intestinal lesions were reviewed. Signalment, physical examination findings, clinicopathologic variables, surgical findings and surgical procedures performed, postoperative data and short-term survival were recorded. Clinical findings included excessive nasogastric reflux and abnormal abdominal fluid. Horses with ESIGL were significantly more likely to require intestinal resection and anastomosis and produced significantly less reflux postoperatively than horses with other strangulating small intestinal obstructions. Geldings were significantly more likely to develop ESIGL than mares or stallions. Quarter Horse or Quarter Horse type breeds were predisposed to ESIGL. Survival to hospital discharge in horses with ESIGL (16/22; 72.7%) was significantly higher than that of horses with other strangulating small intestinal obstructions (92/183; 50%). ESIGL was more prevalent in this population of horses evaluated for acute abdominal pain than in previous studies, accounting for 10.7% of all horses with strangulating small intestinal lesions. Geldings and Quarter Horse or Quarter Horse related breeds are predisposed to this condition. The prognosis for survival to hospital discharge was fair to good.