One of the most challenging time periods in a dairy cow’s life is when she gives birth and transitions into lactation (the ‘transition’ period). This chapter reviews the latest research assessing the welfare of transition cows. The chapter begins by focusing on the biological health of dairy cows before and after giving birth, as cows are at high risk of disease post-calving. It then goes on to discuss the affective states of transition dairy dairy cows, including pain associated with labor and disease. Finally, the chapter concludes by assessing the natural maternal behavior of cows before calving through a case study.