This study investigated whether the modifications made to Grand National (GN) fences at Aintree, Liverpool, UK in 2012 following the Review of Safety and Welfare commissioned by the British Horseracing Authority (BHA), reduced the number and severity of ridden horse falls. The study also investigated whether the number of fences in a race and the total starters were positively linked to falls, and whether horse and jockey experience had any bearing. Videos of 36 races run between 2008 and 2016 recording all horse falls were retrospectively reviewed. Eighteen of the races were run prior to the 2012 changes made to the fences and 18 after the modifications. Falls were graded using a pre-determined severity scale, and previous experience of jumping GN fences. The severity scale was developed by the authors based on the literature and their perception of the degree of injury caused to the rider. The number of falls pre- and post-GN fence modification were adjusted to generalised linear models using the number of falls and severity of falls as dependent variables. A significant decrease in fallers was seen (P<0.001) after changes were made to the GN fences, together with a reduction in the probability of all levels of severity of fall. The severity scores decreased with increasing number of fences (P<0.001). When there were more starters in a race, a greater probability of horse falls was observed (P<0.001). No positive association between horse’s experience of jumping GN fences and horse falls, or jockey licence and horse falls was found (P>0.05). This study revealed that by implementing the changes recommended by the BHA, which included modifying the GN fences, the number and severity of ridden horse falls decreased. Horse and rider welfare was improved, contributing positively to the debate and public perception of the horseracing industry.