Desmotomy of the accessory ligament of the deep digital flexor tendon is a frequently performed surgical techniquein foals to treat flexural limb deformity of the distal interphalangeal joint. In this retrospective study with 40foals varying in age from 15 days to 18 months, 53 desmotomies were performed. The follow-up period varied from2 to 12 years. In 85% (34/40) of the foals a desmotomy had a successful outcome. Both type 1 and 2 flexural deformitiescould be corrected.Preoperative changes in hoof conformation, which appeared especially in older foals (mean age 10.2 months),could also be corrected. The prognosis in foals with a bilateral flexural deformity was less favorable. Changes of thedistal phalanx on radiographic examination seemed to play a role in preoperative lameness but did not have any effecton the post-operative outcome of the desmotomy.Although changes in hoof conformation in older foals can successfully be corrected through desmotomy, surgicalcorrection in young foals is preferred, since changes in hoof conformation in these patients are rather rare. In theopinion of the authors, desmotomy should not be postponed if conservative treatment does not improve a type 1 deformitywithin a couple of weeks, or in case of severe deformity (type 2).