There is an urgent need for dairy practitioners to become more involved in managing the health of transition dairy cows on many large dairies. Veterinarians can become involved at the level of properly diagnosing and treating disease and at the level of disease prevention. Specific tools that veterinarians can use include objectively monitoring transition-cow health with an emphasis on monitoring early lactation death loss, getting into post-fresh pens to observe disease diagnosis and treatment, evaluating on-farm euthanasia procedures, evaluating handling and care of downer cows, encouraging proper recording and monitoring of transition-cow diseases, using on-farm data to identify risk factors for disease, and intensively monitoring key health outcomes such as hypocalcemia, ketosis, and lameness. The veterinarian’s role in transition cow health monitoring may be enhanced by establishing ongoing monitoring programs, which provide longer-term involvement than troubleshooting only.