Failure to inhibit proteinases can lead to excessive tissue damage. The possibility that the severity of endometritis in Thoroughbred mares correlates with the haplotypes of plasma alpha 1-proteinase inhibitor (alpha 1-PI) expressed was investigated in two groups of mares. In mares with pyometritis before treatment, the frequency of the N haplotype, which is already high in the Thoroughbred population, was significantly increased when compared with that in a large published population. In mares with acute endometritis which persisted after treatment followed by sexual rest, the absence of S and T haplotypes was significant, suggesting that, when present, they may have a protective function.