The purpose of this systematic review was to synthesize the research literature on equine-assisted services for motor outcomes of autistic children. Eligible articles published between June 2012 and June 2023 were identified through electronic database searches, including PubMed, PsycINFO, CINAHL, and Web of Science. The Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines were adopted. Twelve articles met the inclusion criteria, and the extracted data included study characteristics, equine-assisted service features, and major motor outcome findings. Significant improvements were identified in coordination, strength, balance, posture, and overall motor skills, affirming the efficacy of equine-assisted services in enhancing motor outcomes of autistic children. To advance future equine-assisted service studies, prioritization of motor outcomes as primary variables is recommended. This emphasis should be evident in research aims, standardized measures, and terminology used to describe equine-assisted services.