• Each year 9,900 equestrians present at Accident and Emergency Departments, 40% of them 10-19 year old females. • The most common horse-riding injuries are to the head, brain, neck and face, torso and extremities. • Because of the relatively larger head, children more often fall on their head. Wearing a helmet gives considerable protection. • Despite the common use of a helmet by horseback riders, serious head injury still occurs regularly. Further research into improvement of the protective function of the helmet is indicated. • The current safety vest (body protector) does not significantly reduce the risk of torso injury. Improvement of its protective function is necessary. • Injury to the lower extremities is caused when they become trapped in the stirrup in a fall from or with the horse. Safety stirrups and sturdy footwear are possible preventive measures. • Investment in the quality and promotion of preventive measures could reduce the frequency and severity of equestrian injuries.