Purpose: The purpose of this study is to examine the effects of postural control training using a horseback riding simulation on the spinal alignment of children with cerebral palsy. Methods: This study was conducted with 30 children with cerebral palsy at levels I~IV in the Gross Motor Function Classification System (GMFCS), and they were randomly divided into a control group and a hippotherapy group. Both the control group and the experimental group received NDT for 30 minutes per session, four times per week for ten weeks, while the experimental group also received hippotherapy 15 minutes per session, four times per week for ten weeks, after the neurodevelopmental treatment (NDT). The horseback riding simulators (JOBA, EU7805, Panasonic) used in this study simulated actual horse movements. Trunk imbalance, pelvic torsion, and pelvic tilt were measured in each group before the exercise and five weeks and ten weeks after the beginning of the exercise using a spinal structure analysis system (ABW Mapper). Results: The Intra-group effects on trunk imbalance, pelvic torsion, and pelvic tilt according to the exercise periods after the hippotherapy were tested, and the results showed significant interaction effects between the groups and the periods (p<0.05). Conclusion: The horseback riding simulation exercise was shown to be effective for the spinal alignment of children with cerebral palsy. Therefore, additional studies should be conducted with more children with CP divided by type.