Lameness is now widely accepted as one of the most important animal welfare concerns facing the global dairy industry. Previous work has shown that the prevalence of lameness and related injuries vary regionally and among farms. The objective of the study was to describe the prevalence of lameness, and hock and knee injuries of high producing cows on freestall farms in the United States. Two hundred forty-eight farms were visited between 2012 and 2014. Farms were in California (CA; n = 38), the Midwest (IA, IL, IN, KS, MI, MN, ND, OH, SD, WI) (MW; n = 77) and the northeast (CT, MD, ME, NH, NY, PA, VT) (NE; n = 133). Evaluation of all cows in the “high-producing” group were performed as they exited the parlor for lameness (5-point numerical rating system (NRS), where 1 = sound and 5 = severely lame; categorized as clinical lameness (NRS ≥ 3) and severe lameness (NRS ≥ 4)), knee injuries (where 0 = sound and 1 = swollen and/or open wound) and hock injuries (where 0 = sound, 1 = loss of hair and swollen, 2 = excessively swollen and/or open wound). The prevalence of clinical lameness averaged 27.2 ± 11.9%, ranging from 5.5 to 70.1% between farms. This prevalence was 8–10% higher in the MW (27.4 ± 11.2%) and the NE (29.3 ± 11.7%) than in CA (19.5 ± 10.9%). The prevalence of the other ailments followed the same pattern. Severe lameness averaged 2.1 ± 2.0% in CA, 3.9 ± 4.2% in MW and 4.2 ± 4.4% in NE. Less than 1% of cows in CA had swollen knees, in comparison to approximately 3% of cows in both the MW and NE. Hock injury prevalence averaged 12.0 ± 7.8% in CA, 20.3 ± 22.5% in MW, and 33.3 ± 21.9% in NE. Severe hock lesions were almost nonexistent in CA (0.3 ± 0.6%), but higher in MW (1.6 ± 2.8%) and NE (2.6 ± 3.6%). These results indicate that lameness and leg injuries remain prevalent, and underscore the importance of efforts to reduce these problems.