Pseudomonas syringae pv. aesculi (Psa) is an emerging bacterial pathogen responsible for a recent epidemic of bleeding canker of European horse chestnut (Aesculus hippocastanum) in northwest Europe. Very little is known about the infection biology of this pathogen, which can cause lethal cankers in the branches and stem of its host. In this study, branches and whole trees of European horse chestnut naturally infected with Psa were subjected to detailed morphological and histological examination to identify the primary infection sites, the time of infection, and the patterns of subsequent lesion expansion within the host. Lesions developed during the host dormant season on the 2003–2009 extension growth increments and were centred mainly on lenticels, leaf scars and nodes. The oldest lesion developed in the 2004/2005 dormant season and the number of new lesions increased in each subsequent year. The lesions developed in the cortex and phloem and extended into the cambium to cause cankers, but there was no evidence of necrosis in the xylem. All lesions on the branches were discrete and apparently contained by a necrophylactic periderm, although there was evidence that Psa could survive within such periderms and subsequently breach them. Examination of two whole 30-year-old trees revealed extensive, continuous cankers in the phloem and cambium which had formed within a single growing season. Thus, the success of Psa as a tree pathogen and the causal agent of a large-scale epidemic may in part reflect an ability to infect the aerial woody parts of its host directly.