Feed management during the transition period can play an important role in the cow’s reproductive tract recovery and function following parturition. The objective of this study was to determine the effects of feeding a fully acidified dietary cation-anion difference (DCAD) diet prepartum to Holstein cows (n = 76) at 2 different concentrations of dietary calcium (Ca) inclusion on uterine environment postpartum. Multiparous Holstein cows were enrolled at 50d before expected calving and followed until 75 DIM. Treatments began at 28d before expected calving and were CON (n = 23), a positive DCAD diet with low dietary Ca (0.4% DM); LOW (n = 22), a fully acidified DCAD diet (urine pH = 5.7) with low dietary Ca (0.4% DM); HIGH (n = 25), a fully acidified DCAD diet (urine pH = 5.7) with high dietary Ca (2.0% DM). Uterine health was evaluated at 4, 7, 10, 13, 15, 17, and 30 DIM by evaluating vaginal discharge for signs of metritis via Metricheck in 2 ways: a MC score (0–3, where 3 is a discharge containing ≥50% purulent material) and by smell score (0 or 3, where 0 is no smell and 3 is a putrid smell). Swabs of the endometrium were collected at 15 and 30 DIM, streaked onto slides, stained, and scanned using whole image scanning. Polymorphonuclear leukocytes (PMN) were counted and a percentage was calculated from these slides. Data collected were analyzed using PROC MIXED in SAS. Contrasts included CONT1 (CON vs average of LOW and HIGH) and CONT2 (LOW vs HIGH). Cows in CON (1.82 ± 0.11) tended to have a lower (P = 0.06) MC score than the average of cows in LOW and HIGH (2.07 ± 0.12) and cows in LOW tended (P = 0.11) to have higher MC score than cows in HIGH (1.97 ± 1.08). There were no differences observed between treatments in the proportion of PMN cells present in the uterus. In conclusion, the uterine health of cows fed LOW appeared to not recover as well as cows fed CON or HIGH after parturition.