Background: Established or ongoing septic arthritis requiring repeated joint flushing remains a treatment challenge with a poor survival outcome aggravated by the necessicity of controlled antimicrobial usage. Objective: To describe the outcomes and survival rates of patients with synovial sepsis treated by lavage with a 0.05% chlorhexidine solution. Study design: Clinical retrospective observational study. Methods: Patients with synovial sepsis who underwent standing needle or arthroscopic lavage under general anaesthesia with a 0.05% chlorhexidine solution, followed by Lactate Ringer Solution (LRS). Complementary systemic and regional antibiotics were used. Short (6 months) and long term (>1 year) evolution were assessed. Results: 10 horses met the inclusion criteria. Affected joints included metacarpophalangeal joints (20%), tarso-crural joint (10%), radiocarpal and intercarpal joints (20%), distal interphalangeal joints and navicular bursa (30%), distal interphalangeal joints (20 %). Time from onset to referral ranged from 1-20 days, mean 8.3 days. Eighty percent of horses survived for more than one year. Four horses were retired to the field, three returned to a light level of work and one went back to full work. Main limitations: Retrospective study of a limited group of horses initially treated by different clinicians before referral, as such, first line treatment had differences between cases. Resolution was evaluated on clinical signs rather than clinical pathology of synovial fluid due to clinical decision or difficulty in obtaining samples. Conclusion: With this series of challenging synovial sepsis cases treated by lavage with a chlorhexidine solution we provide a treatment protocol, proof of clinical concept and report patient’s short and long-term clinical evolution. Short and long term post-operative lameness should be expected despite resolution of the septic arthritis. This treatment poses a novel option for challenging cases but should be regarded as a salvage procedure due to the possibility of long term mild lameness.