BackgroundComputed tomography (CT) of the axial skeleton is increasing across many equine hospitals. CT of the pelvis and caudal spine in a large group of clinical cases has not been reported previously.ObjectiveTo describe the pathological lesions identified in the caudal spine/pelvis in horses and ponies undergoing CT spine of this region.Study designA retrospective case series.MethodsHorses with CT imaging of the caudal spine/pelvis were included. Horses aged under 6 months and those with CT examinations performed post‐mortem were excluded.ResultsFifty‐six horses met the inclusion criteria. Ages ranged from 8 months to 20 years and bodyweights from 85 to 680 kg (mean 488 kg). Horses presented predominantly for lameness (30/56) and poor performance (18/56). Osseous pathology was identified in 41/56 horses; including osteoarthritis of the sacroiliac joint(s) (n: 28), pathology of the intervertebral disc joint(s) (n: 12), pelvic fractures (n: 9), osteoarthritis of the coxofemoral joint(s) (n: 8), ventral spondylosis (n: 6), acetabular rim fracture (n: 2), dislocation of coxofemoral joint(s) (n: 2), and dorsal dermal sinus of the sacrum (n: 1).Main limitationsThe relationship between CT imaging findings and clinical signs in horses remains unclear. Further work is required to describe the relationship between congenital, developmental, and acquired changes in the caudal spine and pelvis, and clinical signs.ConclusionsCT of the caudal spine and pelvis can be utilised in horses and ponies for diagnosing a range of clinical disorders that may be causing ‘lumbosacroiliac pain’, poor performance, hindlimb lameness, and stiffness. The pathologies we observed were diverse and many patients had multiple lesions.