Equine veterinarians trained in acupuncture (AP) often systematically palpate acupoints to detect increased sensitivity (AP scanning), in order to predict and localize lameness and other problems in horses. Although case reports have been published, there are no previous clinical studies on the correlation of positive AP scans (sensitivity of 1 or more acupoints) and lameness. The authors hypothesized that a positive AP scan would correlate with a positive conventional lameness examination. One hundred and two client-owned horses were presented for routine acupuncture, reduced performance or lameness. Each horse first underwent a <2-minute screening scan of acupuncture points and was classified as positive or negative for acupoint sensitivity. Then each horse was evaluated for lameness and categorized as lame or sound. In the sound group, 40/51 (78.4%) horses had a negative AP scan and 11/51 (21.6%) had a positive AP scan. In the lame group, 9/51 (17.6%) horses had a negative AP scan and 42/51 (82.4%) had a positive AP scan (p<0.001). Acupuncture scanning had a sensitivity of 82.4% to detect lameness and a specificity of 78.4%, with an accuracy of 80.4%. Significant but modest correlations existed between the side of the horse that was positive on the AP scan and the side of lameness. The conclusion of the study was that an AP scan could be a useful, quick screening tool during the physical examination to identify horses that should undergo a full lameness examination and other diagnostic testing.