A total of 33 draft horses suffering from cutaneous pythiosis were referred to Mansoura Veterinary Teaching Hospital, Egypt, between October 2008 and January 2011. The animals presented ulcerative, granulomatous lesions located at the ventral aspect of the thorax (n = 10), abdomen (n = 14), forelimbs (n = 5), hind limbs (n = 2), and presternal region (n = 1) and at withers (n=1). The animals suffered from ulcerations composed of whitish yellow tissue having numerous draining tracts that discharge serosanguineous or bloody exudates. Initial diagnosis was based on location, gross lesion, and presence of kunkers. Histopathological evaluation revealed an eosinophilic granulomatous reaction associated with intralesional hyphae characteristic of Pythium insidiosum visualized by Gomori methenamine silver stain. The outcome of surgical excision revealed complete cure in 24 cases. Euthanasia was indicated in 9 cases.