The aim of this study was to compare the effects of caudal epidural bupivacaine alone (BP), bupivacaine plus morphine (BPMP), and bupivacaine plus ketamine (BPKE) for perineal analgesia in horses. Each of the six saddle horses received a caudal epidural catheter and underwent 3 treatments: BP, 0.25% (0.04 mg/kg) bupivacaine hydrochloride without epinephrine; BPMP, 0.02 mg/kg of bupivacaine combined with 0.1 mg/kg of morphine-preservative free; and BPKE, 0.02 mg/kg of bupivacaine combined with 0.5 mg/kg of ketamine. The order of treatments was randomized. The cardiovascular system, respiratory rate, quality of analgesia, sedation, and motor blockade were assessed before drug administration (baseline), at 5, 10, 15, and 30 minutes, and every 30 minutes thereafter until loss of analgesia. The median time to onset of analgesia was 5 minutes after BP treatment, faster than after BPKE or BPMP treatments, which were 10 minutes and 15 minutes, respectively (P < .05). The BPMP treatment produced analgesia (315 minutes) for a longer duration than BP treatment (210 minutes) or BPKE treatment (240 minutes), in the regions of the tail, perineum, and upper hind limb in horses. All treatments presented mild sedation or motor blockade. There were minimal effects on the cardiovascular system and respiratory rate. BPMP may be preferable to a high dose of BP or BPKE. Caudal epidural BPMP can be an appropriate choice for regional perineal analgesia in horses.