The objective of this study was to determine the association among different on the incidence of lameness, hock lesions, and thin cows on US dairy operations. This study was conducted as part of the National Animal Health Monitoring System’s Dairy 2014 study, which included dairy operations in 17 states. Size categories were assigned as follows: small (30–99 cows), medium (100–499 cows), and large (≥500 cows). Trained assessors visited 192 dairy operations between March and July 2014, and recorded locomotion and hock scores (on a 3-point scale), and the number of thin cows (BCS <2.25) on a total of 22,773 cows (average 119 cows per farm). The majority of dairy cows (90.3%) were considered to be sound (LS = 1), 6.9% were mild/moderately lame (LS = 2), and 2.8% were severely lame (LS = 3). Similarly, most dairy cows (87.3%) had no hock lesions (HS = 1), 10.1% had mild lesions (HS = 2), and 2.6% had severe hock lesions (HS = 3). A limited percentage of cows (4.2%) were thin. Univariate comparisons were performed using PROC LOGLINK, which accounts for study design and weighting. Statistical significance was declared at P < 0.05. Herd size had an effect on all parameters examined, with the percentage of cows scored as LS2, LS3, HS2, HS3, and thin increasing as herd size decreased. Additionally, the percentage of cows scored as LS2, HS2, and HS3 differed by housing type, primary flooring type, and primary bedding material used, and cows scored LS3 differed by housing type and primary bedding used. Operations that housed cows on pasture had fewer LS2 and LS3 cows than those that housed cows in tie-stalls or freestalls, whereas operations that housed cows in open/dry lots had fewer HS2 and HS3 cows than those that housed cows in tie-stalls, freestalls, or on pasture. Feeding a TMR and having a nutritionist balance rations for dairy cows was associated with a lower percentage of thin cows. Although herd size was found to be an important indicator of the percentage of LS2, LS3, HS2, HS3, and thin cows on dairy operations in the US, other housing and management practices were also found to have an effect.