Subclinical ketosis is an important and common condition of early-lactation dairy cattle. It is associated with losses in milk production and increased risk of periparturient disease. Prevention depends on several factors, including proper transition-cow nutrition, management of body condition, and the use of certain feed additives such as niacin, propylene glycol, and ionophores. All currently available cowside tests for subclinical ketosis have certain limitations in their use. Effective monitoring schemes for subclinical ketosis can be developed, however, and these may be useful in many herd health programs.