This capstone aims to identify the therapeutic benefits of hippotherapy and equine-assisted activities and therapies in children with disabilities. Current evidence supports occupational therapy in the equine environment, including hippotherapy and equine-assisted activities and therapies, to improve children’s motor, social-emotional, executive functioning, sensory processing, and communication skills positively impacts their occupational performance and participation in their daily lives. The development of this program proposal utilized evidence-based, client-centered approaches incorporated into the occupational therapy model of practice in the equine environment for the pediatric population with disabilities. Hippotherapy provides an accessible, client-centered, evidence-based, enriched environment and engaging alternative to traditional interventions and clinic settings. The proposed program will provide an accessible, effective, evidence-based, and client-centered intervention in a non-clinical setting children find enjoyable and motivating. The proposed program will promote the inclusion of HPOT into a child’s broader treatment plan as a beneficial, evidence-based option for children with various disabilities impacting their occupational performance and quality of life.