The fatalities associated with the riding and handling of horses in South Australia over the 11-year period 1973-1983 are reviewed. There were 18 deaths, including two sudden natural deaths in the saddle and one drowning. The 15 cases of horse-related trauma represent a death rate of approximately one per million population per annum. Thirteen of the deaths were the result of a head injury after a fall. Nine persons were not wearing protective headgear. The two principal groups at risk were male professional riders with a mean age of 32 years and female amateurs with a mean age of 19 years.