Abstract Agalactia is characterized by reduced milk production after farrowing, resulting in economic losses due to increased piglet mortality. Although a variety of management factors have been associated with the etiology of agalactia, a specific causative mechanism has not been identified. Since clinical signs of agalactia develop in the days following farrowing, the objective of the current study was to determine if periparturient immune cell profiles and circulating biomarkers are predictive of future agalactia. Blood samples and litter weights were collected from sows (n = 374) within 24-36 hours after farrowing (timepoint 1) and sows were subsequently monitored for symptoms of agalactia and gaunt piglets. When a sow was designated as agalactic (n = 36) blood samples and litter weights were collected again (timepoint 2) and also from a parity matched healthy control sow (n = 46) of the same day of lactation. Agalactia diagnosis occurred on average 9.25 ± 2.67 d after farrowing. Average daily gain (ADG) of piglets from agalactic sows was 55% less (P < 0.01) than ADG of piglets from controls. Additionally, piglet mortality was substantially greater (P < 0.01) in litters from agalactic sows compared with controls. Circulating immune cells and metabolites were determined. Cholesterol, blood urea nitrogen, and globulin were increased 22.3, 17.8, and 34.1%, respectively, in agalactic compared with control sows at timepoint 2 (P ≤ 0.01). Aspartate aminotransferase tended to increase in agalactic sows compared with control at timepoint 1 (P = 0.08). No differences in immune cell profiles were observed between agalactic and control sows at either timepoint (P ≥ 0.14). Collectively, these data suggest metabolic changes are occurring in sows experiencing agalactia compared with healthy herd mates, but that very few of the metrics analyzed at timepoint 1 predicted future agalactia. This project was supported by Zoetis; TI-07023.