An integrated approach involving reproductive management, health, and nutrition was used to improve dairy herd reproductive performance. This 2-yr project was characterized by frequent farm visits for herd evaluation, blood and feed sample collection, in-depth evaluation of reproductive management practices, radiographic evaluation of insemination technique, disease testing, blood profiling, and computerized ration evaluation and feed programming. Major problem areas identified that contributed to poor reproductive performance were inefficient estrous detection, inadequate vaccination programs and health records, high incidence of reproductive disease and poor uterine health, errors in insemination technique, and various aspects of feeding management. Cost effective management practices were recommended to correct problems. The degree of improvement was variable among herds. Overall there was a reduction in actual calving interval (13.9 to 13.6 mo), days open (137 to 121), days to first service (94 to 85), reproductive culling (36 to 25%), overall services per conception (3.0 to 2.5), and an increase in first service conception rate (32 to 44%). Suggestions for conducting integrated reproductive management studies are discussed.