This study was to investigate the effects of cognitive learning horse riding exercise in using the simulation on pelvic movements and pain and cognitive ability in the elderly patients with chronic low back pain. In order to achieve the purpose of this study, 36 elderly patients with chronic low back pain at K located in C city, were selected at random and allocated 12 elderly women each for the Non Exercise Group (NEG/n=12)and Deficient Exercise Group (DEG/n=12) and Over Exercise Group (OEG/n=12) the measured kinematic pelvic movements and pain and cognitive ability before and after the experiment. The data obtained from this study were analyzed using the SPSS 24.0 statistical program the two-way repeated measures ANOVA and Bonferroni post-hoc test was performed. The cognitive learning horse riding exercise for 16 weeks. The results of this study were as follows: First, there were significantly increased in pelvic movements in OEG compared with DEG and NEG after 12 weeks. Second, there were significantly decreased in pain in OEG compared with DEG and NEG after 12 weeks. Third, there were significantly increased in cognitive ability in OEG compared with DEG and NEG after 12 weeks. As conclusions, this study confirmed that the cognitive learning horse riding exercise in using the simulation could improve the pelvic movements and cognitive ability of elderly patients with chronic low back pain.