Study design: Assessment of spasticity before and after hippotherapy treatment. Objective: To evaluate the short-term effect of hippotherapy on spasticity of spinal cord injured patients (SCIs). Setting: Swiss Paraplegic Centre, Nottwil. Methods: 32 patients with spinal cord injury with various degrees of spasticity had repeated sessions (mean 11) of Hippotherapy-K s . Spasticity of the lower extremities was scored according to the Ashworth Scale. Results: In primary rehabilitation patients Ashworth values after hippotherapy were significantly lower than before (Wilcoxon's signed-rank test: Po0.001). Highest improvements were observed in SCIs with very high spasticity. No significant difference between short-term effect in paraplegic and short-term effect in tetraplegic subjects was found. Conclusions: Hippotherapy significantly reduces spasticity of lower extremities in SCIs.