The objective of this study was to evaluate the ability of milk infrared spectra to predict cow lameness score (LMS) for use as an indicator of cow health on Australian dairy farms, or as an indicator trait for genetic evaluation purposes. The study involved 3,771 cows from 10 farms in Australia. Milk infrared spectra collected during the monthly herd testing were available in all the farms involved in the study. Lameness score was measured once in each herd, within 72 h from a test day, and merged to the closest spectra records. Lameness score was expressed on a scale from 0 to 3, where 0 is assigned to sound cows and scores 1 to 3 are assigned to cows with increased lameness severity. Partial least squares discriminant analysis was used to develop prediction models for classifying sound (score 0) and not-sound cows (i.e., cows walking unevenly, score greater than 0). Discriminant models were tested in a 10-fold random cross-validation process. Milk infrared spectra correctly classified only 57% of the cows walking unevenly and only 59% of the sound cows. When additional predictors (parity, age at calving, days in milk, and milk yield) were included in the prediction model, the model correctly classified 57% of the cows walking unevenly and 62% of the sound cows. The same model applied only to the cows in the first third of lactation correctly classified 66% of the cows walking unevenly and 57% of the sound cows. When the prediction model was used to identify lame cows (scores 2 and 3), only 49% of them were classified as such. These results are considered to be too poor to envisage a practical application of these models in the near future as on-farm tools to provide an indication of LMS. To investigate whether, at this stage, predictions of the LMS could be useful as large-scale phenotypes for animal breeding purposes, we estimated (co)variance components for actual and predicted LMS using 2,670 and 24,560 records, respectively. As the genetic correlation between actual and predicted LMS was not significantly different from zero, predictions of lameness from milk spectra and additional on-farm variables cannot be used, at this stage, as an indicator trait for actual LMS. More research is needed to find better strategies to predict lameness.