A 10-year-old Warmblood gelding presented with a left hindlimb lameness. Diagnostic analgesia located the lameness to the stifle. Radiography showed an unusually large cyst in the distal femur. Diagnostic arthroscopy of the stifle did not reveal any significant abnormalities. An extra-articular transcortical approach to the cyst was performed for drainage, curettage, and provision of an autologous, cancellous bone graft, gentamicin-impregnated collagen fleeces and injectable steroid. The horse returned to a higher level of competitive dressage than prior to surgery. This report describes a large cyst in the distal femur of a horse.