Twenty geldings (five groups; similar age and BW) were used in a completely randomized design experiment to determine effects of grain supplementation of an alfalfa-cube diet on apparent nutrient digestibility and hindgut fermentation. The geldings were housed individually, fed their diets in two equal meals (0600 and 1800), and adapted to five dietary treatments over 6 wk. The treatments were alfalfa cubes (1% of BW; DM basis) without (control) or with one of four rolled cereal grains (i.e., barley, corn, naked oats, or oats) to provide a target level of 0.4% of BW as total nonstructural carbohydrates (TNC). Due to acute laminitis, three geldings (one in the control group and two in the barley group) were excluded. Because of this and multiple incidents of gas colic, TNC level was decreased to 0.2% of BW to ensure the geldings' health throughout the adaptation (7 d) and sample collection (5 d) periods. Grain intakes varied (P < 0.05) and reflected the different TNC concentrations. Apparent digestibilities of DM, OM, CP, NDF, ADF, and cellulose were not affected (P > 0.05) by grain supplementation and averaged 63.2, 63.1, 79.5, 42.7, 39.9, and 50.3%, respectively. Regardless of the source, grain supplementation increased (P < 0.05) apparent digestibility of TNC (from 85.6 to 94.6%) and decreased (P < 0.05) fecal pH (from 7.04 to 6.74). Fecal concentrations of total VFA (mg/g of DM) were greatest for the barley and naked oats diets (averaging 11.73), intermediate for the oats diet (8.00), and least for the control and corn diets (averaging 5.00; P < 0.05). Fecal concentrations of lactate (microg/g of DM) were greatest for the barley diet (254), intermediate for the oats diet (138), and least for the remaining diets (averaging 100; P < 0.05). Fecal concentrations of NH3 N (mg/g of DM) were greatest for the naked oats diet (1.68), intermediate for the barley and oats diets (averaging 0.86), and least for the remaining diets (averaging 0.63; P < 0.05). Serum concentration of lactate was 46% higher (P < 0.05) for the control than for the grain diets (averaging 0.05 mg/100 mL). Feeding barley, corn, naked oats, and oats contributed to 13, 15, 8, and 20% higher (P < 0.05) serum NH3 N concentrations than the control diet (0.25 mg/100 mL). Higher (P < 0.05) serum concentrations of urea N (mg/100 mL) were detected for the control, barley, and naked oats diets (averaging 25.28) than for the corn or oats diets (averaging 22.21). Results suggest that horses consuming alfalfa cubes could be supplemented with rolled barley, corn, naked oats, or oats at levels not exceeding 0.2% of BW as TNC without affecting nutrient digestion or overall health negatively.