Working horses are still an important source of income for many families located in urban and peri-urban settings. An adequate health state in these horses is a prerequisite for welfare and work output, this is why the aim of the present study was: i) review the main systemic health problems; ii) describe their morphological characteristics; and iii) classify the drugs used in urban draught horses between 1997 and 2009. Morphological and health information was compiled for 263 horses from a total of 1132 clinical records between 1997 and 2009 by the free healthcare service. Most horses were geldings (38.4%) followed by mares and stallions. The average age was 8.5 years and only 30.4% presented characteristics of a draught type of horse. The main health systemic problems were related to the Integumentary, Locomotor and Respiratory systems respectively, being skin lesions, lameness and nasal discharge the principal diagnosis for each system. In relation to the drugs administered, dewormers (29.9%), vitamins (29.9%) and anti-inflammatories (14.5%) are the most frequent. Continuous revision of extension programmes is necessary to re-design protocols and adopt proper management practices and optimize the use of resources in a sustainable way. The animal and health information revised in this study can be used to set up new intervention strategies based in the selection of proper horses according to the type of work, and for the incorporation of training programmes aimed towards the prevention of health problems such as skin lesions and lameness and recognition of the risks associated to the use of drugs such as anthelmintics.