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This article reports on the results of a survey of racehorse trainers (<i>n</i> = 112) outlining the reasons for tongue-tie (TT) and noseband (NB) use by Thoroughbred trainers (TBTs) (<i>n</i> = 72) and Standardbred trainers (SBTs) (<i>n</i> = 40). The study also investigated the reported effectiveness of TTs and possible complications arising from their use. Tongue-tie use was reported by 62.5% (<i>n</i> = 70) of racehorse trainers. The reasons for TT use varied between TBTs and SBTs. For TBTs, the most common reason for TT use was to prevent or reduce airway obstruction (72.3%, <i>n</i> = 34), followed closely by to prevent or reduce airway noise (55.3%, <i>n</i> = 16). Standardbred trainers assigned equal importance for TT use [to prevent or reduce airway obstruction (69.6%, <i>n</i> = 16) and to prevent the horse from moving its tongue over the bit (69.6%, <i>n</i> = 16)]. Tongue-ties were considered significantly less effective at improving performance than at reducing airway obstruction and preventing the tongue from moving over the bit (<i>t</i> = −2.700, <i>p</i> = 0.0007). For respondents who used both TTs and NBs, there was a mild to moderate positive association between the reasons for using TTs and NBs. Of the 70 TT-using respondents, 51.4% (<i>n</i> = 36) recorded having encountered either a physical or behavioural complication due to TT use, with redness/bruising of the tongue (20.0%, <i>n</i> = 14) being the most common physical complication reported. Duration of use influenced the risk of observing complications. The likelihood of a respondent reporting a behavioural complication due to TT use increased with every minute of reported application and a nine-minute increment in application period doubled the odds of a respondent reporting a complication. Tightness was a risk factor for physical complications: Checking TT tightness by noting the tongue as not moving was associated with increased reporting of physical complications (OR = 6.59; CI 1.1–67.5). This pilot study provides some insight into how and why TTs are applied by some racehorse trainers, and the potential risks associated with their use. A further study of a larger cohort is recommended because these results are valid for only the 112 trainers who responded and cannot be generalized to the equine industry.