Lameness, injuries, and cleanliness are considered important indicators of dairy cow welfare, milk production, and milk quality. Previous research has identified that farmers globally underestimate the prevalence of these cow-based measurements, but no information on the perceptions of veterinarians is available. Because veterinarians are often perceived as the main providers of health advice on farms, the objective of the present study was to evaluate the relationship between the true prevalence of lameness, injury (hock, knee, neck), and cleanliness (udder, legs, flanks), and the estimated prevalence of these issues by farmers and their herd veterinarians. A cross-sectional study was conducted between February 2016 and July 2017. First, the farm owner and the herd veterinarian were asked to estimate the prevalence of lameness, of neck, knee and hock injuries, and of udder, leg, and flank cleanliness on the farm. The research team then visited the farm and scored all lactating cows in the herd for each measurement. Linear regression models were used to assess the relationship between the prevalence estimated by the veterinarians and the farmers, of each cow-based measurement, and the true prevalence on the farm. The 93 herds enrolled had a median of 55 milking cows and were housed in tiestall (90%) and freestall (10%) barns. Ten herd veterinarians participated and were involved with 2 to 22 enrolled farms each. A wide variation was detected in the true prevalence of the different cow-based measurements among herds (lameness: range = 19-72%, median = 36%; neck injuries: range = 0-65%, median = 14%; knee injuries: range = 0-44%, median = 12%; hock injuries: range = 0-57%, median = 25%; dirty udder: range = 0-55%, median 13%; dirty legs: range = 0-91%, median = 18%; and dirty flanks: range = 0-82%, median = 20%). For both veterinarians and farmers, the perception of each cow-based measurement prevalence increased incrementally as the herd's true prevalence increased. Overall, farmers and veterinarians underestimated cow-based measurements. Farmers and veterinarians more accurately estimated lameness prevalence in herds with higher prevalence than in herds with low prevalence, suggesting a better awareness of the issue on farms with lameness problems. Injuries were less accurately estimated in herds with higher injury prevalence compared with herds with lower prevalence, suggesting an opportunity for better knowledge transfer in this area., (Copyright © 2020 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.)