To investigate the relationships between milk flow traits and udder health status in primiparous cows, 74 primiparous Holstein cows were randomly selected in 5 herds and monitored monthly throughout the whole lactation. A total of 2902 quarter milk samples were collected for bacteriological analyses and the determination of lysozyme, N-acetyl-beta-glucosaminidase (NAGase) and somatic cell count (SCC). Milk flow curves of the whole udder of each cow were registered with continuous electronic milk flow meters. Teat conditions and teat thickness changes during milking were assessed monthly. Quarters, udders and cows were classified as healthy, latent, inflamed and subclinical depending on SCC and the results of bacteriological analyses. Lysozyme in milk, teat apex score and teat thickness change did not vary with udder health status while NAGase in milk significantly increased as udder health status worsened (P<0.001). Milk production (P<0.001) and time of plateau phase (P<0.05) were significantly lower in subclinical cows in comparison with the others. Animals with a high frequency of bimodal curves in the first 100 days in milk showed the worst udder health status during the whole lactation (P<0.01). Moreover, cows classified as subclinical in the first 3 months of lactation had higher peak milk flow than healthy cows (3.81 v. 3.48 kg/min; P<0.05) and shorter duration of plateau phase, expressed both as minutes and as percentage of time of milk flow (pTPL; P<0.001). Multivariate logistic analysis showed udder health status to be associated with duration of plateau phase, time of milk flow, bimodality and duration of overmilking phase. With short time of plateau phase (pTPL <25%), short time of milk flow (<5 min), presence of bimodality and long overmilking phase (>0.8 min) there was an increased risk of poor udder health status. These milk flow traits can be predictive indicators of udder health status; time of plateau phase, expressed as percentage of time of milk flow, can also be a useful parameter for animal selection.