Distal limb lacerations are common injuries in horses, with a better prognosis reported for extensor tendons lacerations compared to flexor tendons lacerations. The objective of the present study was to determine the influence of type and location of injury, modalities of treatment and post surgical complications on the outcome of extensor tendon lacerations. The medical records of 156 horses surgically treated for extensor tendon lacerations over a 10-year period were analysed retrospectively. Information was obtained for 124 horses with a minimum of 18 months follow-up. Statistical analysis was performed on 129 horses (five horses were euthanatized during hospitalization) in order to determine factors affecting outcome. Seventy-four percent of the horses returned to soundness, 17% had moderate gait impairment and 9% remained lame. Approximately 60% of the sports horses returned to an equal or higher level of performance, and 17.5% returned to a lower level. In the multivariate statistical analysis, the only significant factor that favourably influenced outcome was complete suture of the wound. A significant association could not be detected between outcome and absence of a functional extensor tendon, The most important post-surgical complication was extensive scarring of the wound. The present results report outcome of extensor tendon lacerations in a large number of horses and outline the importance of primary wound healing in order to avoid major scarring with potential functional consequences.