A 6-year-old Quarter Horse mare was presented for evaluation with a history of poor performance and unusual behavior while being ridden. The mare had not undergone a conventional lameness or other examination before presentation, but had been evaluated and treated by a chiropractor. The traditional Chinese veterinary medical history and examination of the mare led to a diagnosis of Blood Deficiency with local Qi and Blood Stagnation of the thoracolumbar epaxial musculature, a pattern potentially consistent with ovarian pain. Treatment focused on movement of Qi through the thoracolumbar spine. At the cessation of dry needle and electro-acupuncture treatment, the mare startled and subsequently broke the shaft of a 0.30x50mm needle, within the epaxial musculature at BL-23. The needle was initially treated as a sterile implant with no consequence to the mare, however, ongoing concerns of the owner ultimately led to localization of the needle with ultrasound and surgical removal. This case demonstrates an instance of needle retention with no short-term consequences and that a needle fragment can be localized with ultrasound and removed surgically if warranted.