We determined the clinical signs and blood ionized calcium (iCa) levels in dairy cows with peracute coliform mastitis (PCM). The clinical scores at the onset of the disease (day 0) and on day and subsequent days were significantly (P <0.01) higher than those of healthy cows. We found a positive correlation (r = 0.894, P <0.01) between iCa and total calcium (TCa) concentrations in the blood of healthy cows ; however there was no correlation from day 0 to day 3 in the blood of PCM cows. Multiple regression analysis revealed that the concentration of iCa was correlated with rectal temperature, hematocrit value, platelet count, and albumin level of PCM cows at the onset of disease (r =-0.804, r = 0.6576, r = 0.6182, r=0.284, P <0.01, respectively). There was no correlation between the TCa concentration and these parameters for PCM cows at day 0. Low blood iCa concentration at day 0 for PCM cows was related to symptoms of septic shock involving hypothermia, activation of the blood coagulation system, and dehydration.