Quality of life is dependent upon the extent to which behavioural needs are met, and the balance between pleasant and unpleasant lifetime experiences. In Part II of this systematic review, articles (n = 109) relating to horse-human interactions were reviewed to identify behavioural evidence of their positive or negative impact on the horse. The number of articles (n = 22) relating to the recognition of pain in horses, indicated the importance of identifying health issues, which are also likely to increase the aversiveness of interactions. These and articles relating to emotional reactivity testing in horses (n = 19), the behaviour of horses during handling and management procedures (n = 17), behaviour of the horse when ridden (n = 17), non-procedural horse-human interactions (n = 13), horse behaviour during transportation (n = 12) and behaviour during training other than when ridden (n = 9) were reviewed. During most interactions, horse behaviour is controlled and/or restricted by the human, masking negative or positive signs, and may be confounded by factors including fear and individual differences. In situations involving freedom of movement, positive experiences of horses with humans were associated with approach behaviour, negative ones with avoidance, but training could affect both. Undoubtedly, change is needed to reduce the extent to which interactions with humans are unpleasant for the horse. Only when the needs of the horse are fulfilled and interactions with humans are predominantly pleasurable will their quality of life improve.