BackgroundStandard thoracic auscultation suffers from limitations, and no systematic analysis of breath sounds in asthmatic horses exists.ObjectivesFirst, characterize breath sounds in horses recorded using a novel digital auscultation device (DAD). Second, use DAD to compare breath variables and occurrence of adventitious sounds in healthy and asthmatic horses.AnimalsTwelve healthy control horses (ctl), 12 horses with mild to moderate asthma (mEA), 10 horses with severe asthma (sEA) (5 in remission [sEA−], and 5 in exacerbation [sEA+]).MethodsProspective multicenter case‐control study. Horses were categorized based on the horse owner‐assessed respiratory signs index. Each horse was digitally auscultated in 11 locations simultaneously for 1 hour. One‐hundred breaths per recording were randomly selected, blindly categorized, and statistically analyzed.ResultsDigital auscultation allowed breath sound characterization and scoring in horses. Wheezes, crackles, rattles, and breath intensity were significantly more frequent, higher (P < .001, P < .01, P = .01, P < .01, respectively) in sEA+ (68.6%, 66.1%, 17.7%, 97.9%, respectively), but not in sEA− (0%, 0.7%, 1.3%, 5.6%) or mEA (0%, 1.0%, 2.4%, 1.7%) horses, compared to ctl (0%, 0.6%, 1.8%, −9.4%, respectively). Regression analysis suggested breath duration and intensity as explanatory variables for groups, wheezes for tracheal mucus score, and breath intensity and wheezes for the 23‐point weighted clinical score (WCS23).Conclusions and Clinical Importance.The DAD permitted characterization and quantification of breath variables, which demonstrated increased adventitious sounds in sEA+. Analysis of a larger sample is needed to determine differences among ctl, mEA, and sEA− horses.