Four miniature foals admitted with signs of progressive nonresponsive abdominal pain and no fecal production had fecalith impaction of the small colon. Duration of clinical signs ranged from 10 hours to 5 days. Removal of the fecalith via small colon enterotomy was a successful treatment in all 4 cases. Miniature foals may be predisposed to fecalith impaction of the small colon. If a miniature foal has signs of progressive nonresponsive abdominal pain, fecalith impaction needs to be considered. Surgical correction may be required.