Environmental factors, such as temperature and humidity, exert dramatic effects on the production, health, and well-being of lactating dairy cows. Heat-stressed cows undergo a series of homeorhetic adaptations that alters cellular homeostasis and nutrient utilization. The objective of this study was to determine the effects of cooling and dietary crude protein (CP) content on fermentability of rumen inoculum, milk production, and health of heat-stressed cows. It was hypothesized that cooled but not heat-stressed cows would support productivity in response to an increase in dietary CP content. Thirty-six multiparous Holstein cows were randomly assigned to 1 of 4 treatments in a 2 × 2 factorial arrangement (9 cows/treatment). Treatments consisted of cooling (CO) or moderate long-term heat stress (HS) and diets containing low CP content (LCP; 12.5% CP) or moderate CP content (MCP; 16.1% CP) of dry matter. The CO treatment provided heat abatement with sprinklers and fans that came on at > 20.0°C, whereas the HS treatment did not provide sprinklers and fans. Cows were housed in pens in a freestall barn, and treatments were imposed for 21 d during July and August. Compared with the HS treatment, CO decreased afternoon rectal and vaginal temperatures (0.60 and 0.70°C) and afternoon respiration rate (27.6 breaths/min). Treatment interactions showed that compared with the LCP treatment, MCP increased milk fat yield (23%) in CO but not in HS cows. Compared with the LCP treatment, MCP decreased milk protein percent (0.14 units) in CO but increased milk protein percent (0.09 units) in HS cows. Rumen inoculum collected on d 21 showed a ~3-fold increase in total gas production in vitro in CO compared with the HS treatment. Relative to the LCP treatment, MCP increased plasma glucose and insulin and decreased total free fatty acids concentrations. In summary, under the conditions of this study CO but not HS cows responded to a CP stimulus by increasing productivity.