The objective of this study was to compare the reproductive performance of cows inseminated based on automated activity monitoring with hormone intervention (AAM) to cows from the same herds inseminated using only an intensive timed artificial insemination (TAI) program. Cows (n=523) from 3 commercial dairy herds participated in this study. To be considered eligible for participation, cows must have been classified with a body condition score of at least 2.50, but no more than 3.50, passed a reproductive tract examination, and experienced no incidences of clinical, recorded metabolic diseases in the current lactation. Within each herd, cows were balanced for parity and predicted milk yield, then randomly assigned to 1 of 2 treatments: TAI or AAM. Cows assigned to the TAI group were subjected to an ovulation synchronization protocol consisting of presynchronization, Ovsynch, and Resynch for up to 3 inseminations. Cows assigned to the AAM treatment were fitted with a leg-mounted accelerometer (AfiAct Pedometer Plus, Afimilk, Kibbutz Afikim, Israel) at least 10d before the end of the herd voluntary waiting period (VWP). Cows in the AAM treatment were inseminated at times indicated by the automated alert system for up to 90d after the VWP. If an open cow experienced no AAM alert for a 39±7-d period (beginning at the end of the VWP), hormone intervention in the form of a single injection of either PGF2α or GnRH (no TAI) was permitted as directed by the herd veterinarian. Subsequent to hormone intervention, cows were inseminated when alerted in estrus by the AAM system. Pregnancy was diagnosed by ultrasound 33 to 46d after insemination. Pregnancy loss was determined via a second ultrasound after 60d pregnant. Timed artificial insemination cows experienced a median 11.0d shorter time to first service. Automated activity-monitored cows experienced a median 17.5-d shorter service interval. No treatment difference in probability of pregnancy to first AI, probability of pregnancy to repeat AI, pregnancy loss, time to pregnancy, or proportion of pregnant cows at 90d past the VWP existed. Based on these results, inseminating cows using AAM with hormone intervention can achieve a level of reproductive performance comparable to TAI. Considering the strict cow selection criteria used in this study, interpretation of results for on-farm implementation should be performed cautiously; the results cannot be directly extrapolated to whole herds of cows.