BackgroundBovine mastitis is inflammation of the mammary glands due to physical injury or microbial infection. The disease results in a significant reduction in milk production, hence affecting the dairy industry. The current study is designed to analyze the prevalence of mastitis, detect herd and cow-level potential risk factors, and estimate awareness level of farmers about mastitis. Total 432 cows were selected, by simple random method, from 40 herds of Rawalpindi District (Pakistan) and screened for mastitis. ResultsBased on surf field mastitis test (SFMT) result and clinical examination, 45% prevalence of mastitis was reported at herd-level. The cow-level prevalence was 18.52%, of which 1.85% and 16.66% were clinical and sub-clinical mastitis cases, respectively. The corresponding quarter-level prevalence was 7.58% and the right hind-quarter was most affected. After inoculation of 130 milk samples for bacterial isolation, S. aureus (76.9%) was the predominant etiological agent of mastitis followed by Streptococcus (61.5%). In the multivariable logistic regression model, the herd and cow-level factors significantly associated (p < 0.05) with the presence of mastitis were udder washing before milking, frequency of manure removal, floor type, lactation stage, udder condition, teat end lesion, presence of ticks, use of hormones, milking method and udder and leg hygiene. The Hosmer-Lemeshow goodness-of-fit test suggested that the model fit the data (χ2 = 4.3; p = 0.83) and the final model showed 53.75% sensitivity, 94.9% specificity, 87.27% accuracy, and 70.49% precision. The questionnaire-based survey of the farm handlers regarding the awareness of mastitis and other related factors showed some serious gaps in the perception and awareness of farmers about sub-clinical mastitis and its influence on the economy. ConclusionThe very high prevalence of mastitis, more importantly the sub-clinical one, in the examined herds revealed the huge potential economic loss the sector suffers. Awareness and training of the farmers is essential to enhance the quantity and quality of milk. Alongside awareness, government and International agencies should also help farmers in improving their technical facilities.