An epidemiological study of elite endurance riding was conducted using data from every Fédération Equestre Internationale (FEI) endurance event from 2010 to 2015, comprising 82,917 starts. The aim of the study was to identify risk factors associated with failure to qualify outcomes for horses during FEI endurance rides. The FEI endurance rules state that, during a ride, horses must be assessed by veterinarians several times, giving veterinarians the opportunity to prevent those horses exhibiting signs of lameness or metabolic problems from continuing further. Multivariable logistic regression models were constructed to identify horse, ride and rider level risk factors associated with failure to qualify. Risk factors particularly associated with increased likelihood of failure to qualify due to lameness included age of horse ≥ 9 years, male horse, male rider, field size ≥ 61 horses and if the ride was held in region group II (Northern and Eastern Europe). Factors associated with increased likelihood of failure to qualify due to metabolic problems included whether the ride was held in region group VII (North Africa and the Middle East), ride distance ≥ 100 km and male rider. Some risk factors, such as field size, may be modifiable at the ride level. Other risk factors such as horse age or sex are unmodifiable, but awareness of the risk contributed by these factors can provide veterinarians with additional information while treating horses during endurance rides.