The research included 520 dairy cows on 64 mini-farms in mountainous Serbian areas, with the goal to acquire an insight on acropodium diseases frequency in dairy cows, as well as distribution of hoof alterations. In 56.25% of farms, animals were kept tied in the stable, while 43.75% were grazing regularly or occasionally. Only 10.94% of farms were free of hoof acropodium alterations. Extremely bad hygienic conditions were noted in 18.75% of farms, where 74.01% of animals had acropodium lesions. Based on clinical analysis of 520 dairy cows, 388 of them were diagnosed with acropodium alternations: overgrown hooves (in 21.91% of animals), shoe-like hooves (7.22%), scissors-like (17.27%) and spiral hooves (8.76%). Wounded acropodium skin was diagnosed in 1.8%, interdigital phlegmon in 9.02%, aseptic pododermatitis in 3.61%, digital dermatitis in 4.89%, interdigital dermatitis in 3.09%, hoof ulcer in 3.35%, interdigital blister in 4.89%, hollow hoof wall in 6.18%, horn wall rupture in 0.51%, heel abscess in 3.09%, tendovaginitis in 3.85% and crown joint displacement in 0.26% of animals. We found no pathological lesions of the acropodium in 132 animals (25.38%)