It derives from the draft horses of Belgium but, as a result of isolation and different selective breeding, became genetically distinct from them in the early part of the twentieth century.

[4]: 434 [5]: 166 The American Belgian derives from heavy draft horses of Ardennais, Brabant and Flemish stock imported from Belgium in the latter part of the nineteenth century and in the early years of the twentieth.

Both numbers and demand gradually recovered, and it is now the most numerous breed of draft horse in the United States.

Some are very large: a stallion named Brooklyn Supreme is among the largest horses on record, and was of this breed,[4]: 434  as was Big Jake, a gelding born in 2001, who while alive was listed by the Guinness World Records as the tallest living horse.

[11]: 273 The American Belgian Draft has a high incidence of junctional epidermolysis bullosa, an inherited genetic disorder that affects newborn foals, often resulting in death.