We investigated the effect of body condition loss from the dry to near calving periods on the subsequent body condition change, the occurrence of postpartum diseases, the serum metabolic parameters total cholesterol, triglyceride, glucose, and urea nitrogen and the number of days to first breeding after calving in Holstein dairy cows. Body condition scoring (using a 5-point scale with quarter-point divisions) was performed on 67 pregnant Holstein dairy cows. Cows were scored once for body condition during the dry period (prepartum day 35 +/- 16), near calving (postpartum day 5 +/- 4), and subsequently at months 1 (+/- day 4), 2 (+/- day 5), 3 (+/- day 5), and 4 (+/- day 4) of lactation. At the same time, blood samples were collected to evaluate serum total cholesterol, triglyceride, glucose and urea nitrogen concentrations. Cows were categorized based on body condition loss from the dry to near calving periods into two groups: the moderate condition loss group (0-0.75 points, n=41), or the marked condition loss group (1.0-1.5 points, n=26). Regular reproductive health examination was conducted by the same investigator once a week. The marked condition loss group lost more body condition (P<0.01) than the moderate condition loss group consistently until month 1 of lactation. The recovery of body condition in the marked condition loss group was more delayed (P<0.01) than in the moderate condition loss group from months 1 to 4 of lactation. The occurrence of metritis and metabolic diseases (including abomasal displacement, milk fever, ketosis) was greater (P<0.01) in the marked condition loss group (62 and 23%) than in the moderate condition loss group (27 and 2%), respectively. The total cholesterol concentration was lower (P<0.05) in the marked condition loss group (167 +/- 5.3 mg/dl) than in the moderate condition loss group (183 +/- 5.8 mg/dl) at month 1 of lactation, however, the cholesterol levels at the other periods were not different (P>0.05) between the two groups. The triglyceride, glucose, and urea nitrogen concentrations were not different (P>0.05) from the dry period to month 4 of lactation between the two groups. The number of days to first breeding after calving was longer (P<0.05) in the marked condition loss group (103 +/- 7.8 day) than in the moderate condition loss group (87 +/- 5.3 day). We conclude that marked body condition loss from the dry to near calving periods results in the increased occurrence of postpartum metabolic and reproductive diseases, decreased serum total cholesterol concentrations at month 1 of lactation and a longer interval to first breeding after calving in Holstein dairy cows, probably due to the more severe energy deficit reflected by unfavorable body condition score change during early lactation.