Background: Information regarding mortality associated with standing procedures in horses is sparse. Objectives: To report data from > 12,000 standing sedations. Study design: Confidential, observational, prospective, multicentre, cohort study. Methods: Approved by the Ethical Committee of the Association of Veterinary Anaesthetists (2020-009), we collected records of horses/ponies undergoing standing sedation for surgery or advanced imaging using at least one top-up or constant rate infusion (CRI). Procedures were either NON-COLIC or COLIC. Outcome at seven days was recorded as i) ALIVE, ii) EUTHANASIA or iii) DEAD. Data were collected with a PDF questionnaire, which evolved into a webpage and processed with the statistical software R. Results: Data were collected from 12,307 standing sedations in 61 centres in 23 countries. Death rates were 0.15% overall (19/12,307), 0.13% for NON-COLICs (16/12,237) and 4.29% for COLICs (3/70). The causes of death in the 16 NON-COLICs were abdominal in ten (62.5%), fracture/refracture in three (18.75%), two were “found dead” (12.50%) and one (6.25%) for “other reasons”. In most cases premedication consisted of combinations of alpha-2-agonists/opioids with or without acepromazine. Sedation was maintained using top-ups (9,668/12,307), CRI (3,795/12,307) or CRI + top-up (1,156/12,307). Detomidine was the alpha2-agonist most frequently used for top up (8,258/12,307) and butorphanol the most common opioid (2,754/12,307). Detomidine was the most frequently used alpha-2-agonist for CRI (3,231/12,307); 364 and 305/12,307 received butorphanol and morphine respectively. Only 24.22% received fluid therapy. Locoregional anaesthesia was performed in 37.6% of the cases. Monitoring was minimal, with temperature (5.8%), ECG (3.8%) and pulse-oximetry (0.9%). Main limitations: Sample size, selection bias, questionnaire initially designed for general anaesthesias, potential human errors for data entry and potential missing cases. Conclusions: Standing sedation in horses is not risk free. Horses die unexpectedly within seven days of sedation. Efforts should be made to reduce these mortality rates further.