The objectives of the current study were to determine the association between body condition score change during the dry period (ΔBCS) and postpartum health and reproductive and productive performance of Holstein cows. Data from 16,104 lactations from 9,950 parous cows from 2 dairies located in the San Joaquin Valley of California were used. Within dairy, cows were scored for body condition at dry off and parturition by the same herd workers, who were trained by veterinarians from the Veterinary Medicine Teaching and Research Center of the University of California Davis. Cows were classified as having excessive loss of BCS (ΔBCS ≤-0.75; n = 1,604), moderate loss of BCS (ΔBCS = -0.5 to -0.25; n = 6,430), no change in BCS (ΔBCS = 0; n = 4,819), and gained BCS (ΔBCS ≥0.25; n = 3,251). Data regarding morbidity, mortality, and reproductive and productive performance were recorded until 305 d postpartum or until cows were dried off or left the herd. Loss of BCS during the dry period was associated with greater incidence of uterine disease and indigestion. Additionally, loss of BCS during the dry period was associated with greater likelihood of treatment with antimicrobials, anti-inflammatories, and supportive therapy. Loss of BCS during the dry period was associated with reduced likelihood of pregnancy after the first and second postpartum inseminations. Cows that gained BCS during the dry period had greater yield of milk, fat, and protein and had reduced somatic cell linear score in the subsequent lactation. In the current study, loss of BCS during the dry period was a predisposing factor associated with health disorders and reduced productive and reproductive performance in Holstein cows.