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This article describes diagnosis, treatment, surgical management, and outcome in 16 foals (mean age 7 days of life) affected by confirmed tarsocrural septic arthritis. The chosen therapy was lavage of the synovial cavity performed arthroscopically, once or twice due to recurrence of clinical signs. Information recorded included signalment, history, a complete clinical evaluation, grade of lameness, hematology, biochemistry, serum immunoglobulin G concentration, bone infection radiological findings, cytology and culture of the synovial fluid, treatment, and outcome. Eleven of the foals were males (69%), and five were females (31%). Sepsis affected the right tarsocrural joint in three foals (19%) and the left one in seven foals (44%). Six foals had both hocks affected (37%). In 12 foals (75%), the infection was successfully resolved, and a single intervention was sufficient to have remission of symptoms and resolution of infection. Arthroscopic lavage was repeated in four of 16 foals (25%); five /16 foals (31%) had two joints involved, and the arthroscopic lavage was repeated for all joints. Although the actual literature describes poor possibilities to explore joints in the foal, in this case, it was possible to visualize the inner structures, correctly ascertain and grade the intra-articular damage resulting from infection, and the presence of organic materials inside the joint space. Moreover, what is worth noting is that it was possible to detect and remove fibrin clots thought to be responsible for hiding bacteria and carrying on the infective and inflammatory status.This article describes diagnosis, treatment, surgical management, and outcome in 16 foals with tarsocrural joint–confirmed sepsis.The medical records of all foals under the age of 6 months and presented between 2005 and 2017 for clinical signs attributed to tarsocrural joint sepsis were retrospectively evaluated.This study indicates an effective and rational approach to the diagnosis and management of septic arthritis of tarsocrural joint in foals.