Recently, many changes have been implemented in Dutch dairy herds. Herd sizes have increased and antimicrobial use has been reduced. Certain types of antimicrobials can only be used in specific circumstances, and the preventive use of antimicrobials in dry cows is prohibited. The aim of this study was to quantify clinical mastitis (CM), subclinical mastitis (SCM), and risk factors associated with CM in Dutch dairy herds in 2013, in the context of these changes. For this study, 240 dairy herds were randomly selected from farms that participated in test-day milk recording, used a conventional milking system, and agreed to participate in the study. Eventually, 233 Dutch dairy farmers had complete records of CM in their herds in 2013 and 224 of these farmers completed a questionnaire on management factors potentially associated with CM. All participating farmers gave consent to use their routinely collected herd data such as test-day records and cow identification and registration data. Clinical and subclinical mastitis incidence rate (CMI and SCMI, respectively) per 100 cows per year, subclinical mastitis prevalence, and average bulk tank milk somatic cell count were obtained for 2013. The risk factor analysis was conducted using a generalized linear model with a log link function and a negative binomial distribution on herd level in Stata 13.1. A median CMI of 28.6 per 100 cows at risk per year, SCMI of 70.1 per 100 cows at risk per year, SCM prevalence of 15.8%, and bulk tank milk somatic cell count of 171 × 10(3) cells/mL were observed in 2013. Factors that were significantly associated with a higher CMI were cleaning slatted floors only once per day compared with more than 4 times a day (i.e., mechanical), a higher percentage of Holstein Friesian cows present in the herd, treating less than 50% of the cows with CM with antimicrobials, postmilking teat disinfection, and treatment of cows with elevated somatic cell count with antimicrobials. The results of this study indicated that udder health had not deteriorated compared with udder health in previous Dutch studies where herd sizes were somewhat smaller and before the restrictions in antimicrobial use. Several of the risk factors that were found can be influenced by the farmer and can prevent the occurrence of CMI. Still, when cases of CM occur, treatment with antimicrobials might be necessary to cure the CM case and is beneficial for the overall udder health in the herd.