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Objective: The prevalence of autism spectrum disorder (ASD) is increasing over the years and treatment is becoming more important. The purpose of this study was to investigate the effect of therapeutic horseback riding for children diagnosed with autism spectrum disorder on the quality of life and autistic symptoms. Methods: Twenty-four children with ASD were randomized into one group to perform therapeutic horse-riding activities while the other group did not receive any education or treatment except special education and regular child psychiatric control monthly. Children have been trained in therapeutic horseback riding for one hour a week for eight weeks. Pediatric Quality of Life Inventory (PedsQL) was used for the measurement of quality of life, while autistic symptoms were assessed with the Autism Behavior Checklist (ABC) before and after the training. Results: Statistically significant differences were not found in the quality of life or autism symptoms between the two groups at the beginning of the therapeutic horse-riding activities. There were statistically significant differences between the two groups in terms of physical life quality scores and ABC relationship subscale while there were not statistically significant other subscales of the PedsQL and ABC at the end of eight weeks. When children participating in therapeutic horse-riding activity were assessed before and after activity, statistically significant differences were found in physical, emotional, and psychosocial scores of the PedsQL and the sensory, relationship building, body and object use, language skills, social and self-care skills of ABC. Discussion: It was shown that children who are diagnosed with ASD developed positively in both physical and psychosocial dimension and the severity of ASD decreased after therapeutic horse-riding activities. This results show parallelism with other studies in the current literature. It was suggested that therapeutic horse-riding activities in children diagnosed with ASD could be used as an alternative rehabilitation, even if they were not primer-treatment [Anadolu Psikiyatri Derg 2017; 18(6.000): 630-636]