Background: During an electrochemotherapy (ECT) a chemotherapeutic drug is injected into the tumour and then an electroporation is provided. In horses, ear manipulation may be very painful and combining a loco-regional technique with a sedation might be a good option to avoid anaesthesia-related risks. A two-injection-point block of the internal and external pinna and acoustic meatus was described in horse cadavers, and it permitted complete stain of all three branches of the great auricular nerve (GAN), internal auricular nerve branch (IAB), lateral auricular branch (LAB), and caudal auricular nerve (CAN), suggesting a lower risk of intra-parotid injection during the IAB and LAB block. Case Description: An 8-year-old Italian jumping gelding presented for ECT to treat a fibroblastic sarcoid in the left medial pinna. After intravenous sedation with acepromazine, romifidine, and butorphanol, a two-injection-point block was provided as previously described. The block of the GAN was blind, whereas an electrical nerve locator was used for the IAB, LAB, and CAN. A total of 12 ml of 0.5% ropivacaine was injected. The ECT was safely performed without any difficulties. The horse well tolerated the procedure and completely recovered 75 min after sedation. No complications were detected. Conclusion: The described approach seems feasible and suitable for blockade of the sensory innervation of the equine ear in case of ECT.