Bovine respiratory disease (BRD) is the most expensive disease affecting United States cattle. Recently weaned calves are the focus of prevention and treatment research. Identifying affected cattle early in the course of BRD is difficult. Intervention during the early stages of BRD improves treatment outcomes; however, cattle as prey animals are excellent at hiding signs of disease, especially if the caregiver has not gained their trust. Depression, appetite loss, and changes in respiratory character are the principal signs used to identify BRD. Rectal temperatures from cattle pulled for treatment are a final measure of evaluation. Cattle suffering from subclinical BRD frequently escape identification and treatment. Observations of lungs at packing plants for anterior ventral (AV) lesions frequently document higher BRD incidence rates than observed pre-harvest, suggesting subclinical BRD is common. Data from numerous studies document lower average daily gains (ADG) from cattle with AV lung lesions at packing plants that were not treated for BRD compared with cattle with normal lungs. Scoring lung lesions at the packing plant can be a useful tool for gaining insight into BRD incidence. Data indicate that BRD lowers ADG by 0.2 lbs on average, and lowers the USDA Quality Grade by 50 marbling points.