OBJECTIVE Tibial paresis is commonly seen in bovine practice as a sequel to dystocia. The tibial nerve supplies the extensor muscles of the hock joint and the flexor muscles of the digits; affected cows are lame and have a dropped hock and knuckling of the fetlock. Complete functional recovery occurs not consistently after a conservative "wait and see" approach. The aim of this study was to investigate the usefulness of a cast applied to the lower portion of the affected limb as a supportive treatment of tibial nerve paresis in cows. MATERIALS AND METHODS Eight dairy cows with tibial nerve paresis from different farms were presented for treatment. Seven cows had unilateral tibial nerve paresis and one cow, which was barely able to stand, had bilateral tibial paresis. The affected legs of the seven cows with unilateral paresis and the more severely affected leg of the remaining cow were stabilized using a cast made of synthetic resin. The claws and the skin of the affected limbs were cleaned and a thick layer of cotton was applied to pad the leg from the foot to the hock. A cast was then applied with the foot and metatarsus aligned in a straight line. The cast included the entire foot and extended to the hock. The cast was removed after 4 weeks. RESULTS All of the eight cows could be kept in their normal environment. They were able to walk well with the cast and were only mildly lame. Feed intake and milk yield increased. After removal of the cast, seven of the eight cows walked normally, including the cow of which both legs had been affected. One cow was slightly lame with a dropped hock after cast removal but showed a normal gait 3 weeks later. CONCLUSIONS AND CLINICAL RELEVANCE In cows with tibial paresis, casting of the lower portion of the leg was a useful supportive treatment that resulted in restoration of normal gait. In seven of eight treated cows limb function was normal after 4 weeks, and in one cow after 7 weeks. This supportive therapeutic procedure is straightforward, minimizes aftercare and allows the cow to be kept in her normal environment.