Abstract Objective—To develop an objective, accurate method for quantifying forelimb ground reaction forces in horses by adapting a human in-shoe pressure measurement system and determine the reliability of the system for shod and unshod horses. Animals—6 adult Thoroughbreds. Procedure—Horses were instrumented with a human in-shoe pressure measurement system and evaluated at a trot (3 m/s) on a motorized treadmill. Maximum force, stance time, and peak contact area were evaluated for shod and unshod horses. Three trials were performed for shod and unshod horses, and differences in the measured values were examined with a mixed model ANOVA for repeated measures. Sensor accuracy was evaluated by correlating measured variables to clinically observed lameness and by a variance component analysis. Results—4 of 6 horses were determined to be lame in a forelimb on the basis of clinical examination and measured values from the system. No significant differences were observed between shod and unshod horses for maximum force and stance time. A significant decrease in peak contact area was observed for shod and unshod horses at each successive trial. Maximum force measurements provided the highest correlation for detecting lameness ( r = 0.91, shod horses; r = 1.0, unshod horses). A variance component analysis revealed that 3 trials provided a variance of 35.35 kg for maximum force (± 5.78% accuracy), 0.007 seconds for stance time (± 2.5% accuracy), and 8.58 cm2 for peak contact area (± 11.95% accuracy). Conclusions and Clinical Relevance—The in-shoe pressure measurement system provides an accurate, objective, and effective method to evaluate lameness in horses. ( Am J Vet Res 2001;62:23–28)