The purpose of the present study was to investigate the cow-level association between acute hoof lesions and the somatic milk cell count in dairy cattle. Cows from three loose-housed Swedish dairy herds were enrolled in the study if they had an acute hoof lesion treated by a veterinarian or professional hoof trimmer during the preceding year, according to farmer records. Studied lesions were sole ulcer, dermatitis, interdigital necrobacillosis and hoof abscess, in each case causing lameness. For each hoof-diseased cow, 0 to 3 healthy cows were included, matched with respect to herd, breed, parity and lactation stage. Cell counts were obtained from monthly test recordings from one month before to three months after the hoof-lesion diagnosis, and log-transformed.