One Health (OH) is a crucial concept, where the interference between humans, animals and the environment matters. This review article focusses on the role of horses in maintaining the health of humans and the environment. Horses' impact on environmental health includes their influence on soil and the biodiversity of animal and plant species. Nevertheless, the effect of horses is not usually linear and several factors like plant-animal coevolutionary history, climate and animal density play significant roles. The long history of the relationship between horses and humans is shaped by the service of horses in wars or even in mines. Moreover, horses were essential in developing the first antidote to cure diphtheria. Nowadays, horses do have an influential role in animal assisted therapy, in supporting livelihoods in low income countries and as a leisure partner. Horses are of relevance in the spillover of zoonotic and emerging diseases from wildlife to human (e.g., Hendra Virus), and in non-communicable diseases (e.g., post-traumatic osteoarthritis in horses and back pain in horse riders). Furthermore, many risk factors-such as climate change and antimicrobial resistance-threaten the health of both horses and humans. Finally, the horse is a valuable factor in sustaining the health of humans and the environment, and must be incorporated in any roadmap to achieve OH.Vet. Sci. 2020, 7, 28 2 of 17 crucial part in developing the first antidote to cure diphtheria. Since then, the rate of contact between domesticated horses and humans steadily increased. Nowadays, for example, horses play an important role in animal-assisted therapy. Furthermore, the detection of infectious diseases that affect both humans and horses are crucial, especially in cases of highly transmissible diseases. Beside infectious diseases, non-communicable diseases (NCDs) such as skeletal and joint diseases or metabolic disorders are of concern to both. Several risk factors concerning the health of humans and horses exist. Therefore, this article will give an overview of OH with a focus on horses and their relation to the environment and humans, along with the influence of other factors such as climate change (see Figure 1). Vet. Sci. 2020, 7, x FOR PEER REVIEW 2 of 15 crucial part in developing the first antidote to cure diphtheria. Since then, the rate of contact between 46 domesticated horses and humans steadily increased. Nowadays, for example, horses play an 47 important role in animal-assisted therapy. Furthermore, the detection of infectious diseases that affect 48 both humans and horses are crucial, especially in cases of highly transmissible diseases. Beside 49 infectious diseases, non-communicable diseases (NCDs) such as skeletal and joint diseases or 50metabolic disorders are of concern to both. Several risk factors concerning the health of humans and 51 horses exist. Therefore, this article will give an overview of OH with a focus on horses and their 52 relation to the environment and humans, along with the influence of other factors such a...