Digital dermatitis is linked to approximately 50% of lameness cases in dairy cattle. These hoof lesions may alter cow feeding and estrus behavior. This study investigated how different hoof lesion sizes and the healing status affect cow activity, rumination, and feeding behavior. Over 2 yr, the rear feet of Holstein cows (n = 219) were observed for digital dermatitis lesions during milking once a month. Each lesion was classified as either small (<0.6 cm), medium (0.6 > 1.27 cm), or large (>1.27 cm). Additionally, each lesion was categorized as active (A) or digressing (D), cows with swollen feet were noted. Cow ear temperature, activity, rumination, and eating behaviors were recorded hourly using CowManager. Only behavior data from the day of each hoof evaluation was used for data analysis. Lesion and behavior data were analyzed to compare differences between cows using PROC MIXED in SAS. The percent of time cows were inactive was not affected by hoof lesion size (30 ± 5%; P = 0.58) or healing status (30 ± 1%; P = 0.77). An interaction between ear temperature and hoof ailment was detected, in which, cows with lesions and high ear temperatures spent the least time (34 ± 2%) ruminating, and cows with at least one swollen rear foot and low ear temperatures spent the most time ruminating (44 ± 4% of time; P = 0.03). Hoof lesion size did not influence cow eating behavior (8 ± 1% of time; P = 0.73), but cows with at least one active lesion tended to spend less time eating (7 ± 1% of time) than cows without a lesion (9 ± 0.3%; P = 0.10). High activity was observed more frequently (D: 14 ± 0.6% vs. A: 11 ± 0.9%; P = 0.008) and ear temperature was higher (D: 23.9 ± 0.6°C vs. A: 20.8 ± 0.8°C; P = 0.005) in cows with digressing lesions than cows with active lesions. These results indicate that the size of hoof lesions may not impact cow behavior, but the healing status of lesions may influence cow eating and high activity behaviors. The relationship between ear temperature and hoof lesions should be further investigated. This information implies that heat detection systems, such as CowManager, provide behavioral data that can be used for the early detection of hoof ailments.