The incidence of clinical mastitis in dairy cows was estimated in 171 randomly selected dairy herds from the southern part of The Netherlands. A total of 1103 quarter cases was reported. The mean annual incidence rate was 12.7 quarter cases/yr per 100 cows. The modeling incidence rate of clinical mastitis at the herd level indicated that a number of risk factors were associated with a higher rate of clinical mastitis: one or more cows that were leaking milk, one or more cows with trampled teats, no disinfection of the maternity area after calving, consistent use of post-milking teat disinfection, Red and White cattle (Meuse-Rhine-Yssel) as the predominant breed, and an annual bulk milk somatic cell count < 150,000 cells/ml. The following risk factors were associated with a higher rate of clinical mastitis caused by Escherichia coli: cows with trampled teats, no disinfection of the maternity area after calving, consistent use of post-milking teat disinfection, use of a thick layer of bedding in the stall, and the stripping of foremilk before cluster attachment. The following risk factors were associated with a higher rate of clinical mastitis caused by Staphylococcus aureus: Red and White cattle (Meuse-Rhine-Yssel) as the predominant breed, cows with trampled teats, the stripping of foremilk before cluster attachment, no regular disinfection of the stall, no regular replacement of stall bedding, and an annual bulk milk somatic cell count < 150,000 cells/ml.