The objectives of this study was to evaluate the hospital occurrence of various causes of the distal limb (bones and joints) lameness, radiographically, in equine. Also to evaluate the role of nerve and joint blocks for the localization of distal limb lameness in equine. All the equine lameness cases (n=117), presented during the one-year study period that were subjected to radiographic evaluation, investigated to record the hospital occurrence of various radiographic lesions of the distal limb (bones and joints) lameness in equine. Out of these, 20 equine suffering from lameness were evaluated by systematic evaluation including nerve/joint blocks to confirm, whether the clinically or radiographically detected lesion was the primary cause for the lameness or not. Out of 117, 78 equine (66.67%), were diagnosed with 124 radiographic lesions involving 101 limbs. The majority (62.8%) equine had single radiographic lesion whereas the remaining animals were detected with multiple lesions involving one (15.4%) or more limbs (21.8%). Majority cases of equine lameness were recorded in winter season. Highest per cent lesions were recorded in hoof region (25.81%) with more common involvement of fore feet (68.75%) and in mares (54.54%). Hock and fetlock regions were second (22.6%) and third (21.8%) most common regions for occurrence of equine lameness. Hind fetlock joint (63%) was more commonly affected that fore fetlock joints. In this study, 14 nerve / joint blocks were applied in 13 horses and these were found helpful in confirming the lameness lesions in 61.5% cases. In conclusions, high prevalence of multiple lesions and /or limb(s) involvement makes the diagnostic process for lesion localization challenging. In forelimb, the hoof and in hind limb, the hock are most frequently involved in equine lameness. Periostitis and arthritis are most prevalent lameness causing lesions in equine. Physical examinations, nerve/ joint bocks and radiography complemented each other in confirming the site of lesion causing lameness.