A crossectional study was conducted to identify the major health problems of dairy cattle and associated risk factors in and around Hawassa Town, Southern Ethiopia. A total of 340 randomly selected dairy herd attendants or owners were visited and interviewed using a pre-tested and structured questionnaire. The study herds composed of lactating (573), pregnant (262), and dry cows (91), and heifers (279). The major health problems of dairy cows in the study area were LSD (42.6%), repeat breeding (41.8%), mastitis (25.3%), milk fever (22.4%), diarrhea (29.1%), bloat (16.5%), respiratory problems (23.2%) and FMD (16.5%). Other diseases such as vaginal and uterine prolapsed (13.5%), RFM (13.2%), dystocia (7.6%), and ectoparasites (12.4%) were encountered with low prevalence. The risk factors that had a significant association with selected health problems include breed, production system, hygienic status, deworming per year, water source, herds size, and watering frequency. For example, the GIT problems had a significant difference with large herd size, poor hygienic status, and semi-intensive production system and decreased deworming per year with (P<0.05). Infectious diseases such as FMD and LSD had significantly higher occurrence with large herd size, poor hygiene, reduced drinking water frequency, crossbreed herds, and those herds using river water (P<0.05). Thus, it is recommended that improved animal husbandry especially health management should be in place to minimize the occurrence of major health problems to increase the production and productivity of dairy cows in the study area.