OBJECTIVE To describe the chief complaints by owners and the types and prevalences of musculoskeletal problems associated with lameness or poor performance in cutting horses. DESIGN Retrospective case series. ANIMALS 200 client-owned cutting horses examined at the Texas A&M University Veterinary Medical Teaching Hospital between January 1, 2007, and December 31, 2015, because of lameness or poor performance. PROCEDURES Medical records were reviewed, and data were collected regarding signalment, history, findings on physical and lameness examinations, results of diagnostic procedures performed, diagnosis, and treatment. Distribution of observed proportions of forelimb and hind limb involvement was compared with a hypothetical distribution of 50% by means of a χ2 test. RESULTS More horses were examined because of a recent decrease in performance (116/200 [58%]) than for lameness (84 [42%]). All horses had at least 1 lame limb, with lameness affecting a total of 281 limbs. Of the 281 lame limbs, 189 (67%) were hind limbs and 92 (33%) were forelimbs. These proportions were substantially different from a hypothetical distribution of 50% hind limbs and 50% forelimbs. The most common performance change was that horses would not reverse direction to follow prespecified individual cattle, and the most common cause of lameness was pain localized to the stifle joint region (69 [35%]). CONCLUSIONS AND CLINICAL RELEVANCE Cutting horses sustained more hind limb than forelimb musculoskeletal problems, and although these horses were more likely to be examined for decreased performance than lameness, veterinarians should be vigilant for problems affecting the stifle joint region.