This study's objective was to examine the nature, cause and frequency of injury resulting from equestrian sport in paediatric patients attending two accident and emergency departments. We recorded the attendances of patients aged less than 16 years with equestrian-related trauma in 1 year. Demographic details, injury, mechanism of injury, rider experience and use of protective equipment were noted. There were 41 attendances (39 female, two male, median age 12 years). Thirty-one were injured while mounted, 10 while dismounted. The commonest group of injuries were soft tissue injuries of the lower limb (13 cases), soft tissue injuries of the upper limb (12 cases), fractures of the upper limb (nine cases), and minor head injury (seven cases). There was one case of severe head injury. Two patients required admission to hospital. The commonest mechanism of injury in the mounted group was a fall or throw (23 cases), in the dismounted group injuries were most commonly the result of being trodden on or being kicked (seven cases). The majority of equestrian-related trauma was minor in this study. The possibility of severe trauma exists. Emergency physicians working in areas where equestrian sport is popular should be aware of the likely injuries and their treatment.