The objective of this observational study was to describe animal welfare in freestall housed cattle by creating regional benchmarks across the USA. The data were collected from 535 commercial freestall dairy farms from November 2012 to July 2017. Herd size averaged 1,434 (range 105–13,000) lactating cows. The high production Holstein pen was used and benchmarks were created by geographical region: West (WE; n = 87), Midwest (MW; n = 112), Northeast (NE; n = 277), Pacific Northwest (PNW; n = 42) and Southeast (SE; n = 17). Prevalence of clinical lameness was determined by locomotion scoring (LS; 1 = normal, 5 = severely lame; LS ≥ 3 considered lame) were (lsmean ± SE): 24.5 ± 1.5, 29.7 ± 1.3, 30.6 ± 0.8, 24.1 ± 2.0, and 27.38 ± 3.0 for WE, MW, NE, PNW and SE, respectively. Both WE and PNW regions had lower lameness prevalence than MW (P = 0.01, P = 0.02, respectively) and NE (P < 0.01, P < 0.01, respectively), but were not different from SE. No differences in lameness prevalence among MW, NE and SE. Hock injury prevalence (hair loss and/or swollen) were: 22.6 ± 2.6, 29.1 ± 2.4, 32.1 ± 2.3, 19.8 ± 3.0 and 23.1 ± 3.9 for WE, MW, NE, PNW and SE, respectively. Both WE and PNW had fewer hock injuries than MW (P < 0.01, P < 0.01, respectively), NE (P < 0.01, P < 0.01, respectively), but did not differ from SE. Northeast had more hock injuries than the SE (P = 0.01), but were not different from MW. Knee injury prevalence were 3.8 ± 0.5, 5.1 ± 0.5, 4.7 ± 0.4, 5.1 ± 0.6 and 3.9 ± 1.0 for WE, MW, NE, PNW, and SE, respectively. West had fewer knee injuries than MW (P < 0.01), NE (P = 0.04), PNW (P = 0.02) and were not different from SE. No differences in knee injury prevalence were observed among MW, NE, PNW and SE. Daily lying times (h/d) were 10.14 ± 0.12 for WE, 11.35 ± 0.10 for MW, 11.06 ± 0.06 for NE, 10.05 ± 0.16 for PNW, and 10.00 ± 0.26 for SE. Lying times in the MW were longer than WE (P < 0.01), NE (P = 0.02), PNW (P < 0.01), SE (P < 0.01). Northeast lying times were longer than WE (P < 0.01), PNW (P < 0.01) and SE (P < 0.01). There were no differences in lying time among WE, PNW and SE. Based on these results WE and PNW have better cow comfort than other regions in the USA.