The aim of this study was to assess the effectiveness of safety regulations governing traditional Mongolian horse racing on the frequency and severity of injuries among child jockeys. Regulations introduced in 2019 mandate the wearing of helmets and protective clothing, prohibit the participation of jockeys aged <7 years, and ban horse racing during the cold season (November–April). National injury surveillance data were used to compare the profile of injuries that occurred among children aged <15 years in the 4-year periods before and after the introduction of the regulations (2015–2018 and 2019–2022) and to investigate whether injuries continued to occur among underage children and during the banned season. The proportion of head injuries among injured children was calculated before and after the regulations were introduced. During the study periods, 6309 animal-riding injuries were recorded among children aged 3–14 years; 2539 occurred before the regulations were introduced and 3770 occurred after. Following the introduction of the regulations, the proportion of injured children aged <7 years decreased slightly. However, during 2019–2022, 294 animal-riding injuries were observed among underage children and 855 during the banned season. The proportion of head injuries among children with animal-riding injuries remained unchanged before and after the regulations were implemented (33.7% and 34.6%, respectively). The regulations have been ineffective. To reduce the burden of injuries among child jockeys, safety regulations need to be enforced throughout the year, and more stringent penalties for noncompliance should be imposed.