Study objectives were to evaluate effects of hindgut acidosis in cows acclimated to a low-starch diet. Ten rumen-cannulated Holstein cows (243 ± 20 DIM; 663 ± 18 kg BW) acclimated to a low-starch diet (15% starch) for 17d were enrolled in a study with 2 experimental periods (P). During P1 (4d), baseline data were collected. During P2 (7d) cows were randomly assigned to 1 of 2 treatments: 1) control (CON; 1.5 L H₂O/infusion) or 2) 4 kg/d of starch (ST; 1 kg corn starch + 1.5 L H₂O/infusion) and abomasally infused every 6 h daily. Milk, feces, and blood samples were collected daily. Effects of treatment, time, and treatment by time interaction were assessed using PROC MIXED (SAS Inst. Inc., Cary, NC). Starch infusions markedly reduced fecal pH compared with CON (5.8 vs. 7.2; P < 0.01). Rectal temperature of ST cows progressively increased from d 1–3 of P2 (P = 0.04). Milk yield and DMI were unaffected by treatment. Milk protein content of ST cows gradually increased from d 2–5 of P2, while it remained unchanged in CON (P < 0.01). No treatment differences were observed in milk fat, although, it decreased in ST cows compared with P1 (6%; P = 0.10). Milk urea nitrogen decreased in ST cows from d 1–4 of P2 and then plateaued (P < 0.01). No overall treatment differences were observed for SCC during P2, but it decreased in ST cows relative to P1 (29%; P = 0.04). During P2, circulating insulin increased (47%; P = 0.08) in ST relative to CON, however, glucose and BHB concentrations were unaffected by treatment. Starch infusions decreased BUN concentrations from d 1–5 of P2 (38%; P < 0.01) relative to CON. Similarly, NEFA decreased in ST cows (44%; P = 0.07) while they were unchanged in CON cows. Relative to CON, ST infusions increased circulating monocytes on d 3 (77%; P = 0.04) and decreased basophils on d 0.5 and 7 (both 31%; P = 0.01) of P2. Circulating serum amyloid A and lipopolysaccharide binding protein concentrations were unaffected by starch infusion. In summary, although abomasal ST infusion reduced fecal pH and altered energetic metabolism, little to no effects were observed on inflammation and production in cows consuming a low-starch diet.