Background and Purpose: Cerebral palsy (CP) is a nonprogressive neurological condition that typically causes motor dysfunction. Children with CP often have decreased endurance, balance, and strength. This leads to decreased physical activity and difficulty performing sports with their age-related peers. The purpose of these case studies was to determine whether stand up paddle boarding aquatic therapy (SUPAT) improves gross motor function and decreases the number of falls experienced by 2 children with spastic CP. Case Description: Participants included 2 adolescent girls diagnosed with spastic CP categorized as Gross Motor Function Classification System (GMFCS) level II. Intervention: Over 10 weeks, the patients attended seven 1-hour SUPAT sessions. The sessions included a 10-minute warm-up and a variety of paddle boarding skills. Both participants completed Gross Motor Function Measure-88 (GMFM-88) and reported the average number of falls before and after the SUPAT intervention. During each session, a trial run (the total duration a child could maintain balance on the paddle board) was also measured. Outcomes: Participant 1 increased GMFM-88 scores from 92.5% to 95.5% and trial run duration from 1 minute 24 seconds to 6 minutes 14 seconds. Participant 2 increased GMFM-88 scores from 91.6% to 92.9% and trial run duration from 1 minute 12 seconds to 3 minutes 7 seconds. Both participants reported a reduction in the number of falls. Discussion: These case studies indicated the SUPAT program was beneficial for pediatric patients with CP. Following the SUPAT intervention, both participants improved scores on the GMFM-88 and increased their ability to maintain balance on the board (trial run). These findings support the notion that the SUPAT program is beneficial for increasing gross motor function, improving balance, and decreasing the number of falls. SUPAT could be a viable alternative therapeutic intervention to traditional aquatic therapy and an opportunity to participate in an outdoor sport.