Lameness is a major animal welfare and economic issue for the dairy industry and is a challenge to overcome due to its multifaceted causes. Digital cushion thickness (DCT) is a strong predictor of lameness and is phenotypically associated with incidence of claw horn disruption lesions. The digital cushion is a complex structure composed of adipose and loose connective tissue located between the distal phalanx and the sole. It is important in dampening compression of the corium tissue beneath the cushion. The objective of this study was to characterize the change in DCT within the animal across lactation. Body condition score (BCS), visual locomotion score (VLS), DCT, and presence or absence of lesions were collected at 4 sample events: <40 d prepartum, 1 to 30 d in milk (DIM), 90 to 120 DIM, and >255 DIM for 124 commercial Holstein cows. Cow height was measured at the beginning and end of the study. Cows underwent digital sonographic examination for the measurement of DCT evaluated at the typical sole ulcer site for the right front and hind foot. Factors such as parity number and stage in lactation were obtained from the farm’s dairy management software (DairyCOMP 305). The prevalence of lameness (VLS ≥3) and lesions was greater in parity greater than 1 animals than parity equal to 1 animals. To evaluate the associations with DCT, a mixed linear model was built using MIXED procedure in SAS software. Compared with tall cows, DCT was significantly different by height; thinner for short cows and thicker for average cows. Those that are lame (VLS ≥3) and of average BCS group have significantly thicker digital cushions than those that are lame and of fat BCS group. Among fat BCS group animals, lame cows had significantly thinner digital cushions than cows that were not lame. Those with a lesion at 90 to 120 DIM had the thinnest digital cushion. The hind medial claw was the thinnest claw compared with the other claws. The average DCT of the measured claws at each sample event for parity greater than 1 appears to follow the BCS curve. The results indicate there is not a specific threshold of DCT where a dairy cow becomes lame or incurs a lesion.