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The aim of the present study was to evaluate the associations between milk recording data, body condition score (BCS), housing factors, management factors, and lameness in freestall-housed dairy cows in 3 structurally different regions in Germany. These regions substantially vary regarding herd size, breeds, access to pasture, farm management (family run or company owned), and percentage of organic farms. The data used was collected in a large cross-sectional study from 2016 to 2019. A total of 58,144 cows from 651 farms in 3 regions of Germany (North, East, and South) was scored for locomotion and body condition. Additionally, data on milk yield, milk composition, breed, age, as well as information on housing and management were retrieved. One mixed-logistic regression model was fitted per region to evaluate the association of the data with the target variable "lame" and to allow for a comprehensive reflection across different kinds of farming types. In all regions, undercondition (BCS lower than recommended for the lactation stage; North: odds ratio [OR] 2.15, CI 1.96-2.34; East: OR 2.66, CI 2.45-2.88; South: OR 2.45, CI 2.01-2.98) and mid-lactation stage (102-204 d in milk; North: OR 1.15, CI 1.05-1.27; East: OR 1.24, CI 1.17-1.32; South: OR 1.38, CI 1.18-1.62) were associated with higher odds for lameness, whereas overcondition (BCS higher than recommended for the lactation stage; North: OR 0.51, CI 0.44-0.60; East: OR 0.51, CI 0.48-0.54; South: OR 0.65, CI 0.54-0.77) and parity of 1 or 2 was associated with lower odds (parity 1 = North: OR 0.32, CI 0.29-0.35; East: OR 0.19, CI 0.18-0.20; South: OR 0.28, CI 0.24-0.33; parity 2 = North: OR 0.51, CI 0.47-0.46; East: OR 0.41, CI 0.39-0.44; South: OR 0.49, CI 0.42-0.57), irrespective of the regional production characteristics. Low energy-corrected milk yield was associated with higher odds for lameness in South and North (North: OR 1.16, CI 1.05-1.27; South: OR 1.43, CI 1.22-1.69). Further factors such as pasture access for cows (North: OR 0.64, CI 0.50-0.82; and South: OR 0.65, CI 0.47-0.88), milk protein content (high milk protein content = North: OR 1.34, CI 1.18-1.52; East: OR 1.17, CI 1.08-1.28; low milk protein content = North: OR 0.79, CI 0.71-0.88; East: OR 0.84, CI 0.79-0.90), and breed (lower odds for "other" [other breeds than German Simmental and German Holstein] in East [OR 0.47, CI 0.42-0.53] and lower odds both for German Holstein and "other" in South [German Holstein: OR 0.62, CI 0.43-0.90; other: OR 0.46, CI 0.34 - 0.62]) were associated with lameness in 2 regions, respectively. The risk of ketosis (higher odds in North: OR 1.11, CI 1.01-1.22) and somatic cell count (higher odds in East: increased (>39.9 cells × 1,000/mL): OR 1.10; CI 1.03-1.17; high (>198.5 cells × 1,000/mL): OR 1.08; CI 1.01-1.06) altered the odds for lameness in 1 region, respectively. Cows from organic farms had lower odds for lameness in all 3 regions (North: OR 0.18, CI 0.11-0.32; East: OR 0.39, CI 0.28-0.56; South: OR 0.45, CI 0.29-0.68). As the dairy production systems differed substantially between the different regions, the results of this study can be viewed as representative for a wide variety of loose-housed dairy systems in Europe and North America. The consistent association between low BCS and lameness in all regions aligns with the previous literature. Our study also suggests that risk factors for lameness can differ between geographically regions, potentially due to differences in which dairy production system is predominantly used and that region-specific characteristics should be taken into account in comparable future projects., (© 2023, The Authors. Published by Elsevier Inc. and Fass Inc. on behalf of the American Dairy Science Association®. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).)