Responses of registered Holstein cows to various levels of inbreeding were examined with pedigree data supplied by the Holstein Association USA and test-day production data from 1970 through 1998 obtained from the Animal Breeding Center at Cornell University. Rate of increase in level of inbreeding has been accelerating over time, making it more difficult for producers to make matings that avoid the potentially deleterious effects of inbreeding. Milk production losses per lactation caused by inbreeding were generally 35 kg per percentage inbreeding level >0.01 but increased to 55 kg per percentage inbreeding level from 0.07 to 0.10. Somatic cell score was not affected by level of inbreeding. Inbreeding had the greatest effect on production at ages <22 mo and early in lactation. Early onset of the deleterious effects of inbreeding resulted in larger net present value losses than when effects of inbreeding occurred later. Losses were likely enhanced due to the need to freshen animals as early as possible to maximize net present value returns. Survival decreased as level of inbreeding increased and was likely to have a greater negative impact on the financial health of the dairy enterprise than production losses.