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Draft and pulling horses are used in a traditional equestrian sport in the Valencian Community (Spain), in which horses must pull a cart loaded with a weight equivalent to twice their body weight along a sand track. Although it constitutes cultural heritage, this practice raises questions about animal welfare since it involves working horses under demanding physical exertion. There are no studies evaluating the welfare of horses participating in these draft and pulling competitions using validated clinical, ethological, and physiological indicators, and the present work aims to fill this knowledge gap. A total of 160 horses of different breeds and five weight categories were evaluated across five competitions. Health parameters, body condition, hoof status, presence of lesions, and behavioral responses to the observer were recorded. In 20 horses, heart rate was monitored using a heart rate monitor, and hematological analyses were performed. In addition, owners were surveyed regarding their social profile and management practices. Most horses showed an adequate body condition (74.4% scored 3/5) and a low incidence of harness-related injuries (≤15.6%), mainly superficial abrasions in older horses. Conformation defects were observed at 11.9% and hoof overgrowth at 19.4%. Regarding behavior, 65% of horses remained alert, and 68.8% responded amicably to the evaluator, while younger horses exhibited more avoidance and aggressiveness. During competition, heart rate peaked at 175 bpm, comparable to equestrian sports such as show jumping, with recovery to baseline values within 15 min; hematological analyses were normal in all cases. Overall, we conclude that draft pulling horses show good health and training status, with no evidence of serious welfare impairments. Nevertheless, strengthening hoof care and preventing harness-related injuries through training programs and regular veterinary check-ups is recommended.