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Background: The use of horse-riding simulators in the treatment of chronic low back pain has drawn considerable attention for its efficacy and acceptability to reduce chronic low back pain; because of the similarities in movements provided by equineassisted therapies and the possible accessibility advantages. However, the results are conflicting. This study aimed to perform a meta-analysis of randomised controlled trials to assess the impact of treatments based on horse-riding simulators on chronic low back pain.Methods: A systematic literature search up to January 2021 was performed and 11 studies were detected with 543 subjects with chronic low back pain at the baseline of the study, 257 of them were using horse-riding simulators, and 255 of them were inactive control group who continued their usual care, and similar kind of physical therapy (control). They reported a comparison between horse-riding simulators and control to reduce chronic low back pain. Mean differences (MD) with 95% confidence intervals (CIs) were calculated assessing the impact of treatments based on horse-riding simulators on chronic low back pain using the continuous method with a random or fixed-effect model. Results: Significantly higher change-from-baseline pain outcomes was observed inVisual Analogue Scale (MD, −4.36; 95% CI, −6.24 to −2.30, P < .001), and Roland Morris Disability Questionnaire change-from-baseline (MD, −2.32; 95% CI, −3.52 to −1.12, P < .001) with horse-riding simulators compared with control. Conclusions:Using horse-riding simulators may lower the risk of chronic low back pain. This relationship forces us to recommend the use of horse-riding simulators to avoid any complications that could occur with chronic low back pain.How to cite this article: Ren C, Liu T, Zhang J. Horse-riding simulators in treatment of chronic low back pain: A meta-