The objective of this observational study was to evaluate the association between lameness, ovarian cysts, and fertility in lactating dairy cows. Data analysis of historical records from a 3000 Holstein farm was conducted. Sixty-five cows that became lame within 30 days postpartum were used as cases, and 130 nonlame cows served as controls. The outcome variables were incidence of ovarian cysts (OC, %), conception rate at first service (CRFS, %), overall pregnancy rate (PR, %), and calving to first service interval (CFSI, day), Incidence of OC and CRFS were analyzed by logistic regression, PR by survival analysis and CFSI by ANOVA. Lame cows had a lower CRFS (17.5% versus 42.6%) and higher incidence of OC (25.0% versus 11.1%) than controls (P<or=0.05). Calving to first service interval was not different between lame and control cows (P>0.05). There was a multicollinearity relationship between lameness and ovarian cysts. The results show that cows that became lame within the first 30 days postpartum were associated with a higher incidence of ovarian cysts, a lower likelihood of pregnancy, and lower fertility than control cows. Because this is an observational study it is not possible to conclude a cause-effect relationship.