Dystocia or difficult parturition is one of the real emergencies faced by the equine veterinary surgeon, and effective management is essential for the survival of both the foal and mare, and for the mare's subsequent fertility. Dystocia is most commonly caused by abnormalities of fetal presentation, position or posture, but can also result from fetal oversize, congenital defects of the fetus, or maternal factors such as pelvic abnormalities or uterine inertia. The incidence of dystocia has been reported to be between 4 and 10 per cent of all births. Dystocia may be daunting to the inexperienced practitioner, but needn't be if approached in a methodical way. The aim is always to deliver a live foal as quickly as possible and with minimal interference and trauma to the mare. This article discusses how to identify dystocia and ways to aid successful delivery of the foal.