Equine-assisted therapies are interventions that use the unique qualities of a horse to assist persons with disabilities to improve their gross motor, language, social, and self-help skills. Programs offering these services are varied and operate on all major continents across the world. The effectiveness of equine-assisted therapies is generally supported by research, although most studies have been small and the rigor of much of the research has been less than optimal. This paper describes the different types of riding programs and reviews research examining their effectiveness for children and adults with developmental and acquired motor or cognitive disabilities, and psychological or psychiatric impairments. Recommendations are made for future research to provide evidence of the broader benefits of using horses to enhance the lives of people with disabilities.