Background: according to the center for disease control and Prevention (cdc), an estimated 30 million people ride horses each year in the united states. horseback riding related injuries are common, with an estimated 50,000 emergency room visits annually. The popularity of recreational horseback riding has increased in south Florida and the incidence of associated traumatic injuries is areflection of this.Material and Methods: retrospectivereview of patients admitted to astate designated Level itrauma center that sustainedhorseback ridingassociatedinjuries between january 2000 and december 2003. information extracted from the Tr auma center's data base included demographics, mechanismofinjury and toxicology screening.Results: During the review period, twenty-seven patients were identified. There were 12 men and 15 women. The average age was 36 years. The injuries occurred during pleasure riding in 23 patients and thoroughbred related activities in 4p atients. multiple severe injuries were common and documented in 24 patients. all patients required hospitalization with an average stay of 5days. Five patients had apositive toxicology screen on admission. no deathswere documented in this review.Conclusion: horseback riding related injuries tends to be serious. alcohol and recreational drugs may contribute to exacerbate the extent of these injuries. The use of proper protective equipment, instructions for safe riding, and discouraging drug and alcohol use during riding activities should be emphasized.