The objective was to examine milk production, health, and economic performance among Holstein heifers during first lactation on 3 commercial dairy farms in California. Heifers (n = 1905) were moved to the breeding group between 360 and 390 d of age and grouped retrospectively according to age at first calving (AFC) as low (< or =700 d), medium (701 to 750 d), and high (> or =751 d). Within farm, growing heifers were managed similarly, as were lactating primiparous cows, for the first 310 d in lactation. Heifers were fed to gain 0.70 to 0.80 kg/d from 4 mo of age to breeding, and 0.8 to 0.9 kg/d from breeding to 252 to 258 d of pregnancy. First calving at <700 d was associated with reduced yields of milk and milk components. Cows in the high age group produced more milk fat and true protein than medium and low cows. Incidence of stillbirths was highest for cows in the low group (19.8%), but stillbirths were also a concern for those calving at medium (16.1%) or high age groups (13.5%). Both low and high cows had lower conception rates at first postpartum AI, and abortions averaged 9.8% across groups. Days open and number of inseminations were lower for medium than low cows. Incidence of mastitis and lameness was lowest for cows in the medium group. Culling and mortality rates were not affected by AFC, but among those that died, cows in the low group tended to die earlier postpartum than cows in the high group. Heifers in the medium group had an adjusted income value numerically higher by 138.33 dollars and 98.81 dollars compared with those in the low and high groups, respectively. First calving at <700 d compromised first lactation yields of milk and milk components and impaired reproductive performance. However, extending AFC beyond 750 d did not improve lactation, reproduction, or health of primiparous cows. Although not preassigned to age groups before start of breeding, Holstein heifers managed as in this study had the highest economic return when calving between 23 and 24.5 mo of age.