Basilar skull fractures in horses can occur at any age, although young horses are particularly prone to this type of injury. This manuscript describes two foals with a basisphenoid bone fracture, with clinical presentations ranging from mild neurological signs up to severe neurological compromise. The absence of neurological signs does not exclude a fracture of this bone, as lethargy and retropharyngeal swelling may be the only clinical signs. Radiography can help define skeletal trauma involving the basilar region of the head, but superimposition of complex skull anatomy limits its use. Endoscopy of the guttural pouches region can be also helpful, but it does not provide enough evidence for a diagnosis. Thus, computed tomography is the optimal imaging technique for a rapid and straightforward diagnosis, as it is superior to radiography defining the type of fracture and the location of the fragments as well as the soft tissue involvement.