In a five-year study, 160 accidents occurred among 46,351 six-through 21-year-olds engaged in horse activities. Of these, 130 were riding accidents, 20 were horse-related and 10 did not involve horses. Bruises and abrasions were the most frequent injuries, and the area of the body most commonly injured was the head and face. The low accident rate may result from the requirement that riders wear approved protective headgear.