Aquifer Storage and Recovery (ASR) is a managed aquifer recharge method where water is injected and later extracted using wells. In saline aquifers, ASR performance is often limited by dispersive mixing, which creates a transition zone at the edge of the injected freshwater and buoyancy-driven flow, which causes the freshwater to rise and deform during storage—both reducing recovery efficiency. This study investigates whether horizontal wells can improve ASR performance in saline, low-transmissivity aquifers by achieving acceptable recovery efficiencies and outperforming conventional vertical wells. Three configurations were evaluated numerically with MODFLOW 6: a horizontal well, a fully penetrating vertical well, and a dual well system with a fully penetrating injection well and a partially penetrating extraction well. Models were tested on a large set of parameter combinations from Latin Hypercube Sampling, targeting conditions where vertical wells perform poorly. The horizontal well generally achieved higher recovery efficiencies, with a median of 45% after five ASR cycles, compared to 6% and 16% for the fully and partially penetrating vertical wells. Its advantage was greatest under strong buoyancy conditions, where vertical wells failed to recover any freshwater. While dispersive mixing reduced horizontal well performance by causing earlier saltwater breakthrough, it improved vertical well recovery by stabilizing the injected freshwater. In conclusion, horizontal wells are promising for ASR when hydraulic conditions require multiple vertical wells and when buoyancy-driven flow significantly limits vertical well performance.