Background: Horse riding is a hazardous activity with the potential for serious injury. Equestrian-related injuries account for a higher rate of injury per number of riding hours than motorcyclists and automobile racers. There is a lack of literature pertaining to equestrian-related brain injuries. The objectives of this study were to describe the incidence, characteristics, and mechanisms of equestrian-related brain injuries sustained amongst Canadians between 1990 and 2014. Methods: Data were obtained from the Canadian Hospitals Injury Reporting and Prevention Program (CHIRPP) database. The study population consisted of individuals who sustained equestrian-related brain injuries between the years 1990 and 2014 and presented to one of 15 participating emergency departments. Results: Brain injuries accounted for 13.3% (N=1060) of all equestrian-related injuries. The greatest proportion of injuries occurred amongst individuals aged 15-19 years, followed by individuals aged 0-4 years. The predominant mechanism of injury was falls. 17.9% of individuals were admitted to hospital. Normalized rates of injury increased from 1990 to 2010. Conclusions: Brain injuries sustained while participating in equestrian are often of a greater severity than injuries sustained while participating in other recreational activities. A clear understanding of the epidemiology and mechanisms of equestrian-related brain injuries must be achieved in order to effectively implement prevention efforts.