Our objectives were to characterize dairy farms, milk yield, and nutritional strategies in 3 different regions of Colombia and determine associations with blood BHB concentrations in the first 42 DIM. Dairy herds (n = 55) in the Antioquia, Caldas, and Cundinamarca regions of Colombia were visited once from May through July 2018. A survey was administered to farm owners to collect management and nutrition information. Whole blood [BHB] was measured from dairy cows (n = 868) between 1 and 42 DIM using a point-of-care device. Associations between nutritional strategies and blood [BHB] were examined using mixed models. Prevalence of hyperketonemia was calculated as the number of samples with [BHB] ≥ 1.2 mmol/L divided by the total number samples. The estimated early lactation diet composition was 65.5% pasture, 31.8% commercial concentrates, and 2.7% other feed ingredients. The median (range) milk yield, [milk protein], and [milk fat], were 21.0 kg (13.1 to 36 kg), 3.2% (2.7 to 4.1%), and 3.5% (3.0 to 4.1%), respectively; mean (±SE) milk yield differed by region at 22.3 ± 0.12 kg, 20.8 ± 0.20 kg, and 20.0 ± 0.20 kg in Antioquia, Caldas, and Cundinamarca, respectively (P < 0.001). Median (range) blood [BHB] was 0.5 mmol/L (0.1 to 4.4 mmol/L), and mean blood [BHB] did not differ between regions (P = 0.16). Overall prevalence of hyperketonemia was 4.0%. Geographical location affected the prevalence of hyperketonemia at 2.4%, 4.0%, and 9.6% in Antioquia, Caldas, and Cundinamarca, respectively (P < 0.001), possibly due to production differences or unmeasured management variables. Neither commercial concentrates nor pasture as percent of estimated early lactation diet intake were associated with blood [BHB] (P ≥ 0.14). Our results suggest that pasture-based dairies in Colombia have lower early lactation blood [BHB], hyperketonemia prevalence, and production yields compared with confined production systems in temperate zones; further epidemiological work is needed to establish the suitability of the commonly used hyperketonemia cut-point for pasture-based dairies in tropical regions.