Abstract: Equine-assisted psychotherapy and therapeutic riding for veterans with posttraumatic stress disorder (PTSD) has been increasingly studied but not meta-analyzed. We identified 2,609 records from database, backward (i.e., reference), and forward (i.e., citation) searches to identify 18 studies addressing effectiveness. The studies were published from 2013–2021 with sample sizes ranging from 5–85 and quality ratings medium – high. Equine-assisted services show large significant effects for change during treatment (n = 14, d = 1.156), follow-up (n = 6, d = 0.994), and compared to waitlist control (n = 1, d = 0.842), and medium effects compared to treatment-as-usual (n = 3, d = 0.465). Examination of these four types of evidence suggests promise for the use of equine-assisted services with veterans for reduction of PTSD symptomatology and a need for more controlled studies, particularly in relation to other specialized treatments also assessed as effective in treating PTSD in veterans.