Consumption of horse milk has become popular in developed countries, especially among people suffering from bowel problems and skin diseases. Since the positive effect is supposedly not observed after pasteurisation, the product is mostly consumed as raw milk. Since the microbiological quality of this milk has not been systematically surveyed, in this study we examined the presence of spoilage- and pathogenic microorganisms in 123 samples of horse milk collected in The Netherlands and Belgium. Hygiene and faecal indicators were found in a wide range of numbers. Although Salmonella, Campylobacter and Listeria were not found, these pathogens showed no reduction in challenge tests with artificially contaminated horse milk stored for 1 week at 7 °C. Since faecal indicators were present and able to grow at 7 °C, combined with the fact that pathogens may easily end up and survive in the milk, it is not advised to consume raw horse milk.