Pedigree and race run data from Thoroughbreds racing in Southern Africa, covering the period 1986-2002 (63 146 horses in pedigree data-set and 778 532 race runs), were analysed in order to study genetic and environmental factors affecting the incidence of epistaxis as associated with “exercise-induced pulmonary haemorrhage” (EIPH). Variables that were tested as significant in preliminary data analyses were included as fixed effects for the model. Various combinations of such variables namely age, weight, altitude, sex, month and going were tested. Fixed effects that were included in the final model were gender, going and altitude. The heritability estimates from a logit transformed analysis for epistaxis fitting both the animal and sire models were 0.23 and 0.40, respectively, which indicated that epistaxis as associated with EIPH in Southern African Thoroughbred sires has a strong genetic basis. Genetic trends indicating an increase in epistaxis were also found. Affected stallions and those racing whilst being treated with furosemide should be barred from breeding and not be considered as future sires. Estimated breeding values for epistaxis should be used as a tool for selecting against it and be considered in breeding programmes to decrease the incidence thereof.