Lameness is considered one of the most important health and welfare issues in the dairy industry. Understanding the total cost per case of disease-specific lameness can help producers select better treatment, prevention, and control strategies for their herds. The first objective of our research was to calculate the costs associated with 3 lameness causing hoof diseases: digital dermatitis, sole ulcer, and white line disease. To accomplish this, a survey of hoof health professionals (hoof trimmers and veterinarians) was conducted to identify treatment related expenditures per case. Data from the hoof trimmer responses to the survey and previously published research were incorporated into a farm-level stochastic simulation model to determine the expected costs per case of each disease and the most influential factors associated with disease costs. The cost per case was calculated by disease type, severity (mild or severe), incidence timing (0 to 60 days in milk, 61 to 120 days in milk, 121 to 240 days in milk, or > 240 days in milk), and parity group (primiparous or multiparous). The second objective of our research was to determine the economic value of investing in different lameness prevention strategies. Two prevention strategies were considered: 1) prevention of infectious hoof diseases and 2) prevention of non-infectious hoof diseases. The total expenditures (therapeutics, outside labor, on-farm labor, and prevention costs) and losses (discarded milk, reduced milk production, extended days open, increased risk of culling, increased risk of death, and recurrence losses) associated with each prevention strategy before and after prevention implementation were calculated and compared to find the breakeven investment cost.