This study hypothesizes that heat stress adversely affects dairy cows, resulting in reduced rumination, altering eating and drinking behaviors, changes in their locomotory patterns, and significant variations in their acid-base balance. The aim of this study was to investigate the impacts of heat stress on rumination, drinking, and locomotory behavior, as registered by innovative technologies, and acid-base balance in fresh multiparous dairy cows. This study was conducted during the summer, from 15 June to 8 July 2023, on a Lithuanian commercial dairy farm. We assessed 350 German Holstein cows that produced an average of 11,400 kg of milk annually throughout their second and subsequent lactation periods. We used the temperature-humidity index (THI) to divide the cows under investigation into three periods: I. high HS-THI >78 (period: 15-23 June 2023); II. medium HS-THI 72-78 (period: 24-30 June 2023); and III. low HS-THI <72 (period: 1-8 July 2023). The appropriate RumiWatch sensor (RWS) parameters were assessed between 15 June 2023 and 8 July 2023. Cows were acclimatized to the rumination, drinking, and locomotory behavior parameters during the adaptation period (1-30 June 2023). The registration process started on 15 June 2023 and terminated on 8 July 2023 and was performed every hour during the 24 h day. The acid-base balance was recorded from 15 June 2023 until 8 July 2023, once per week. The cows' activity increased by 11.75% in the high HS period compared to the low HS period (p < 0.01); high mean differences were detected for rumination, which was 17.67% higher in the high HS period and 13.80% higher in the medium HS period compared to the low HS period (p < 0.01); and the change in activity was 12.82% higher in the low HS compared to the medium HS period (p < 0.01). Cows under high HS had higher blood urea nitrogen (BUN) levels compared with cows under medium HS (p < 0.01). The observed alterations in the rumination, drinking, and locomotory behaviors, in addition to the acid-base balance, highlight the multifaceted impacts of varying heat stress on the physiological and behavioral responses of dairy cows. This suggests that the utilization of advanced technologies may assist dairy farmers in effectively monitoring and controlling heat stress in cows. Additionally, regularly assessing blood urea nitrogen levels can enable farmers to modify their feeding practices, thus promoting optimal cow well-being and productivity.