OBJECTIVE: To report a technique for improving surgical access to the bladder for removal of cystic calculi in male horses. STUDY DESIGN: Retrospective case series. ANIMALS OR SAMPLE POPULATION: Geldings (8) with cystic calculi. METHODS: After catheterization of the bladder through the penis, 100 mL 2% lidocaine hydrochloride solution was instilled. After 10 minutes, the bladder was distended with sterile, warmed Hartmann's solution to a pressure of ≈ 40 cm H(2) O, using gravity feed. This was left in place until abdominal access was gained at surgery, then the fluid siphoned off via the catheter. RESULTS: Calculi were 3-11 cm in diameter (median, 6 cm). Bladder capacity ranged from 1.4 to 2.5 L (median, 1.8 L). Exteriorization time from placing a hand in the abdomen to having the bladder in a surgically accessible position was <5 minutes. CONCLUSION: The described technique facilitates exteriorization of the bladder for removal of cystic calculi.