Injuries sustained as a result of horse riding are common. Serious injuries to the nervous system are the most dangerous. An analysis has been made of 11 papers, new ®gures produced by surveying Stoke Mandeville, Oswestry and Odstock spinal units and by searching the internet to determine their frequency and distribution. Head injuries outnumber spinal injuries by ®ve to one. In contrast to other sporting accidents, there are more lumbar and thoracic than cervical injuries and more women are injured than men (though this may just be a re¯ection of the fact that there are more women riders than men). Of all horse riding activities, jumping is most likely to produce a spinal injury.