Objective—To develop and assess the short-term feasibility, maintenance, and complications associated with percutaneous endoscopic gastrostomy (PEG) tube placement in standing horses. Animals—6 adult horses. Procedures—Feasibility of the technique was evaluated in 2 horses. In each of 4 other horses, a PEG tube was maintained for 14 days and used to provide fluid requirements during the latter 7 days, before removal. Following air inflation of the stomach, each PEG tube was placed via a left intercostal approach; proper tube location was ascertained by percutaneous ultrasonography and gastroscopy. The horses underwent physical examinations, CBCs, and peritoneal fluid analyses before and at intervals after tube placement. Seven days after tube removal, horses were euthanized and necropsied. Results—Placement of a PEG tube was feasible in all 6 horses. The 4 horses assessed long term tolerated water administration through the PEG tube and remained clinically stable throughout the 21-day experiment. However, during the period PEG tubes were in place, significant increases in some peritoneal and hematologic variables were detected. Postmortem evaluation revealed localized peritonitis in 1 horse and body wall inflammation along the PEG tube tracks in 3 additional horses. Conclusions and Clinical Relevance—Placement and maintenance of a PEG tube were tolerated well by the study horses, although peritoneal and systemic inflammation were detectable. Fluid requirements were adequately met with this technique, which could provide an alternative method for managing chronically dysphagic horses. Nevertheless, further research is warranted to evaluate the feasibility of enteral feeding by use of this approach in horses.