The man, whose name has not been released, became only the third person known to have lived through a fall over the massive cataract without safety devices.
Canada's Niagara Parks Police said witnesses reported seeing the man climb over a retaining wall about 20 feet above the brink of the falls at mid-morning and deliberately jump into the swift waters.
He surfaced a few seconds later in the lower Niagara River Basin below, near an observation platform, police said.
He "was located by a Niagara Parks Police officer along the rocky shoreline as he collapsed in waters that were up to the subject's waist," police said in a statement.
In a rescue that lasted about 30 minutes, staff from several agencies extricated the man, thought to be about 40 years old.
He had sustained life-threatening injuries and was flown by an air ambulance to a hospital in Hamilton, Ontario, for treatment, the statement said. Police were investigating how and why he went over the falls.
The Horseshoe Falls, one of the world's most popular tourist attractions, sends about 675,000 gallons (2.6 million liters) of water over its edge per second. It is one of two massive waterfalls, along with the American Falls, that span the U.S.-Canada border.
Decades ago, daredevils would tempt fate and go over the Horseshoe Falls in barrels or other protective devices - and were often killed. That is now an illegal stunt that can result in a fine or jail time.
In 2009, an American man survived an unaided plunge over the falls, after a U.S. tourist survived a suicide attempt over the falls in 2003. A young boy who was wearing a life jacket survived a fall over the cataract in 1960 after the boat he was in capsized.
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