Medical records of horses that underwent surgical treatment for colic between 1990 and 1992 were reviewed. Horses with a pulse rate of > or = 60 beats/min or signs of abdominal pain, which were also accompanied by a volume of > 2 L of material that refluxed from the stomach during the postoperative period (excluding horses with anterior enteritis), comprised the postoperative ileus (POI) group. Horses that had < 2 L of material reflux during the postoperative period and survived > 3 days after surgery comprised the reference population. The association of preoperative and intraoperative clinical variables with development of POI was evaluated by use of logistic regression analysis. Of 148 horses, 117 were assigned to the reference population, and 31 (21%) developed POI. Multiple logistic regression analysis was used to determine that PCV, pulse rate, type and location of lesion detected during surgery, and serum glucose concentration were the most important variables associated with development of POI. Time of recovery from anesthesia to development of POI was 0.5 to 120 hours (median, 13 hours). Duration of POI was 1 to 7 days (median, 1 day). Four of 31 (13%) horses with POI died. Of 148 horses, only 10 (7%) died; however, 4 of the 10 (40%) deaths in the short-term postoperative period were attributable to POI.