In the United States each year an estimated 30 million people ride horses, resulting in 50,000 emergency room visits (1 visit per 600 riders per year). A survey of 679 equestrians in Oregon, Washington, and Idaho estimated that at some time in their equestrian career one in five will be seriously injured, resulting in hospitalization, surgery, or long-term disability. Among survey respondents, novice equestrians had an incidence of any injury that was three-fold over intermediates, fivefold over advanced equestrians, and nearly eightfold over professionals. Approximately 100 hours of experience are required to achieve a substantial decline in the risk of injury. The survey authors conclude that efforts to prevent equestrian injury should focus on novice equestrians.