Abstract: The results of a standardised radiological examination of 5928 Hanoverian Warmblood horses selected for sale at auction were used to predict relative breeding values (RBV) in the 23,662 horses included in the last four generations of the probands' pedigrees. The distribution of the RBV was investigated in the whole four-generation pedigree, in the probands and in those stallions that contributed at least three offspring to the probands. The RBV of the probands' sires were further compared with the officially published performance-based relative breeding values, i.e., total indices dressage (TID) and jumping (TIJ). The sires' level of dressage indices was considerably higher (mean TID=110) than of the jumping indices (mean TIJ=98). Total indices radiographic findings (TIR) were calculated for the sires with varying weighting given to the individual RBV. In each case, this resulted in a mean TIR of 99. Finally, total indices were derived from TIR and TID and/or TIJ in order to develop different selection schemes for all-purpose breeding and for breeding focused on dressage and show jumping. All breeding values under consideration increased by between 1% and 19% when radiographic findings were weighted with between 30% and 60% complementary to the corresponding performance parameters, and when only sires were selected with above average total indices. At the same time, the prevalences of the radiographic findings investigated here were lowered by up to 10% each. When only one radiographic finding was considered at a time, the maximum attainable response to selection was a 16-23% increase in the relative breeding values and a relative decrease in prevalences of radiographic findings of between 31% and 52%. The results of this study indicate that it is possible in horse breeding to consider simultaneously health and performance traits. Medical data should be included in the prediction of breeding values in order to improve the radiological status of today's riding horses.