The author previously observed the presence of localized tender points on the concave surface of the external auricle of horses with clinical signs of localized somatic pain. No similar point sensitivity was detected on the auricles of horses that were free of pain. The objective of this descriptive clinical study was to compare the presence or absence of auricular point pain with conventional physical examination findings to determine the validity of auricular diagnosis to predict when musculoskeletal pain was present or absent. One hundred performance horses (varying ages, breeds) presented for locomotor problems were randomly selected from the author’s clinical practice. All horses first received palpation of the concave surface of the auricle (external ear) with either the medial or lateral edge of the thumb and the results were recorded. After the auricular examination, a complete conventional musculoskeletal/orthopedic examination was performed to detect pain of the head, body and limbs. Results of the auricular and conventional examinations were then compared. Good correlation (> 70% in both sensitivity and specificity) between the auricular diagnosis and the conventional examination was found in the head, low cervical region, shoulder, upper/lower thoracic regions, lumbar and sacral regions. No conclusions could be drawn regarding the reliability of auricular diagnosis for other regions. The findings of this study indicate that auricular diagnosis may be a useful tool in clinical practice and support the theory that auricular points represent specific reflex connections between the auricle and corresponding somatic areas.