[Purpose] The aim of this study was to examine the effects of horse riding exercise using a horse riding simulator (HRS) and a ball on static and dynamic balance of elderly people. [Methods] Thirty-two elderly people hospitalized in geriatric hospitals were randomly assigned to the HRS exercise group or the ball exercise groups, and they performed exercise for eight weeks. [Results] The length of postural sway during quite standing with and without eyes closed significantly decreased in both groups after the exercises and there was no significant difference between both groups in the Romberg test. In the functional reach test (FRT), there were significant increases in distance in both groups after the exercises, and the distance of the HRS exercise group was significantly greater than that of the ball exercise group. In the Timed Up & Go test (TUG) and Timed 10-meter walk test (10MWT), the time significantly decreased in both groups, and there was a more significant decrease in the HRS exercise group than in the ball exercise group. [Conclusion] The results of this study indicate that HRS and ball exercises may improve the balance and gait ability of elderly people hospitalized in nursing homes or geriatric hospitals.