The commercial use of bovine somatotropin to increase commercial milk production is a very controversial topic. Concerns have been raised that bovine somatotropin use will adversely affect cow health. Increased incidence of ketosis, increased incidence of milk fever, increased susceptibility to infectious diseases, chronic wasting and infertility were predicted clinical problems resulting from long-term BST use. This review examines the impact of BST on cow health by reviewing clinical health data from twenty-seven bovine soinatotropin production studies. Cows in bovine somatotropin treatment groups had no increased incidence of ketosis or milk fever. Milk somatic cell counts in BST treated cows did not differ significantly from controls. Bovine somatotropin treated animals, like genetically superior high producing cows, had an increased mobilization of body reserves to support increased milk production and reduced reproductive performance.