Aim:The present study was conducted to ascertain the prevalence of ketosis in dairy cows in dairy herds, milksheds, and mixed population of milk cows selected randomly in milkshed areas of Odisha state, India.Materials and Methods:The investigation was conducted in 280 private dairy herds with variable herd size of 10-15 cows comprising crossbred Jersey cows (CBJ), crossbred Holstein Friesian (CHF) cows, and indigenous local breeds. The analysis of urine (Rothera’s test), milk (Ross test), and blood samples of 2760 test cows were conducted through qualitative assessment by Rothera’s test and Ross test, respectively, for the presence of ketone bodies to screen the ketotic animals. Cut-points have been decided based on β-hydroxybutyric acid level (≥1.2-1.4 mmol/L) in milk.Results:We noted positive cases of ketosis with a prevalence rate of 36.7% (1014/2760) entailing 27.2% in clinical ketosis and 9.6% in subclinical ketosis. The breed wise incident rate was recorded to be the highest (38.0%) in CBJs. The age-wise prevalence rate was found to be the highest (40.8%) in the age group of 5.5-6.5 years. The season wise prevalence rate in 5th calver was recorded to be the highest (38.6%) in summer season as compared to other seasons. The prevalence of ketosis was observed to be the highest at 56.7% on the first stage of lactation at the 1st month after 2 weeks. The incidence rates for clinical and subclinical ketosis were found to be 25.2%; 12.2%, 26.6%; 11.2% and 30.3%; 2.9% in CBJ, CHF and indigenous cows, respectively. The breed wise overall prevalence rate was recorded to be 38.0% in CBJ, 37.8% in CHF, and 33.2% in indigenous cows.Conclusion:Ketosis and subclinical ketosis is highly prevalent metabolic disorder and has severe effect on the production status of affected animal and needs to be prevented, rather than treated, by maintaining cows in good and healthy conditions. We have attempted to give great attention for diagnosis, management, and control of this disease during risk stage to prevent economic loss sustained by the dairy farmers of Eastern India.