A 6-year-old Quarter Horse was examined because of acute, severely swollen masseter muscles (palpation of which elicited pain response), exophthalmos, severe chemosis, and protrusion of the third eyelids. Blood selenium and vitamin E concentrations, and results of feed analysis and muscle biopsy supported a diagnosis of nutritional myopathy. The horse was treated and was clinically normal 2 weeks after discharge from the hospital.