A study of the risk factors associated with mastitis in Sri Lankan dairy cattle was conducted to inform risk reduction activities to improve the quality and quantity of milk production and dairy farmer income. A cross-sectional survey of randomly selected dairy farms was undertaken to investigate 12 cow and 39 herd level and management risk factors in the Central Province. The farm level prevalence of mastitis (clinical and subclinical) was 48 %, similar to what has been found elsewhere in South and Southeast Asia. Five cow level variables, three herd level variables, and eight management variables remained significant (p < 0.05) in the final logistic regression analysis. Expected risk factors relating to unhygienic environments and inadequate knowledge or practice of mastitis control were found. Other factors included parity, milk yield, milking practices, access to veterinary services, use of veterinary products, stall structure, and stall hygiene. Many of the risk factors could be addressed by standard dairy cattle management techniques, but implementation of mastitis control programs as a technical approach is likely to be insufficient to achieve sustainable disease control without consideration of the social and political realities of smallholder farmers, who are often impoverished.