High-frequency jet ventilation was performed on a premature foal for respiratory difficulty attributable to in utero-acquired pneumonia. The procedure involves delivery of compressed gas through a small-bore cannula at frequencies up to 400 cycles/min. Ventilation settings of drive pressure, frequency, and FIO2 were varied to optimize PaO2 and PaCO2 values. The foal was ventilated with this equipment for 14 hours. Evidence of a favorable response to this method of ventilation was observed in the form of improvement in arterial blood gas values as well as the foal's attitude and degree of respiratory effort. High-frequency jet ventilation appears to be a useful method of ventilation for respiratory disease in neonatal foals; however, there remains no clear-cut advantage over conventional positive-pressure ventilation.