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The aim of this review is to provide dairy farm advisors, consultants, nutritionists, practitioners, and their dairy farmer clients with an additional toolkit that can be used in the assessment of the quality of their dairy cattle nutrition. Cow signs are behavioral, physiological, and management parameters that can be observed and measured. They are detected by examining and observing the cattle. Other physiological parameters such as fecal scoring, rumen fill, and body condition scoring are also included in 'cow signs'. The assessment should be both qualitative and quantitative; for example, is the cattle individual lame and what is the severity of lameness. The 'diagnosis' of a problem should be based on establishing a farm profile of 'cow signs' and other relevant information. Information gathered through assessment of cow signs should be used as an advisory tool to assist and improve decision making. Cow signs can be used as part of an investigation and or farm audit.