Examination of the long-term histories and clinical findings was performed in 351 horses suffering from recurrent laryngeal neuropathy (RLN) to examine for possible evidence of progression of this disorder. Fifty-two out of 351 cases (15%) had evidence of progression of the degree of laryngeal dysfunction over a median period of 12 months (range 1.5–48 months) with the onset of progression occurring at median age 7 years. In 30 cases, there was both endoscopic (median deterioration of 3 endoscopic grades; range 1–5 grades) and clinical evidence, with 29 (97%) of these horses concurrently developing sudden-onset, abnormal exercise-related respiratory ‘noises» and 13 (43%) concurrently reporting reduced exercise performance. In the remaining 22 horses there was solely clinical evidence of RLN progression, including the sudden onset of abnormal exercise-related respiratory sounds in 16 (73%) and the worsening of such sounds in 6 (23%), associated with reduced exercise performance in 13 (59%) of these 22 cases. Endoscopically, 13 (59%) of the latter 22 cases had marked (total or almost total) RLN that did not appear compatible with their previous exercise-performance histories. This evidence of progression of RLN may be of particular significance in disputes concerning horses that are apparently normal at pre-purchase examination but are later shown to have RLN and also in the surgical treatment of less severe cases of RLN.