Minimizing the risk of antibiotic resistant organisms and antibiotic residues in dairy and dairy beef products is a topic of nationwide interest. To design an effective outreach program on judicious use of antibiotics, it is imperative to describe the actual practices on dairies. Thus, our objective was to summarize management and treatment practices for fresh cows (FC) on 15 California dairies (600 to 9,500 cows) as a first step in that outreach effort. Data were collected by 2 bilingual veterinarians during the FC evaluations, based on cow-side observations and responses from dairy employees. Daily (n = 14) or thrice a week (n = 1) FC evaluations and treatments administrations lasted [median (range)] 13.8 (1.5 to 45) s/cow. To identify sick cows evaluators relied on thermometer (n = 1), stethoscope (n = 7) or both (n = 3). All dairies visually inspected cows for abnormal uterine discharge. Twelve dairies evaluated 2 to 5 signs of diseases [rumen fill (n = 7), eyes-ears (n = 7), milk yield / udder fill (n = 7), appetite (n = 7), feces (n = 5), temperature (n = 5)]. Antibiotic therapy was given systematically after eutotic (n = 2), twinning (n = 7) and dystotic calvings [all FC (n = 5), primiparous FC (n = 1), severe cases (n = 7)]. Cows with retained placenta were treated at 24 (n = 8), 48 (n = 4) and 72 (n = 3) h postpartum with systemic ceftiofur (n = 9), penicillin (n = 1) or ampicillin (n = 3), or intrauterine urea or essential oils (n = 2). Cows with foul-smelling vaginal discharge were treated for metritis with NSAIDs (n = 3) and systemic antibiotics [ceftiofur (n = 12), penicillin (n = 2) or ampicillin (n = 1)], as well as with antiseptic (n = 1) or antibiotic (n = 2) uterine flushing. Two dairies used antibiotic uterine flushings if systemic antibiotics were ineffective. Non-foul-smelling abnormal vaginal discharge was treated with uterine antiseptic flushings (n = 4). On 2 dairies, antibiotics were the treatment of choice for sick cows with an unknown disease. In this study we have observed that some dairies used antibiotics either as prophylactic therapy or to treat sick cows with unspecific diagnose. Sick cows identification, disease classification, and treatments were not consistent across dairies.