Structural changes lead to increasing sizes of dairy herds and a reduction in grazing use. Thus, cows spend more time in the barn and become more exposed to the barn environment. The cubicle surface can result in damages of the cows’ hock joint integument. Pasture is generally seen as a beneficial environment for cows. We hypothesized that a higher number of daily grazing hours reduce the probability of hock joint alterations in dairy cows from large herds. In total, 3148 lactating cows from 36 grazing and 20 zero-grazing dairy herds, with an average herd size of 173 cows, were assessed individually on one randomly selected body side for alterations in hock integument (score 0 for no alterations or hairless areas ,2 cm, 1 for at least one hairless area of >2 cm, 2 for lesion or swelling). The cows were further assessed for lameness and cleanliness. Information on breed, parity and days in milk per cow was extracted from a national database. Cubicle surface was evaluated for each herd. Daily grazing hours 30 days before herd visits were recorded by the stockmen and later categorized as follows: zero hours (zerograzing), few hours (3 to 9) and many hours (.9 to 21). The effects of daily grazing hours and other potential cow and herd-level risk factors were evaluated for their impact on hock integument alterations using a logistic analysis with a multi-level model structure. The probability for hock integument alterations such as hair loss, lesions or swellings decreased with increasing amount of grazing hours (odds of 3 to 9 h 2.2 times and odds of .9 to 21 h 4.8 times lower than of zero-grazing). The probability for only lesions or swellings decreased with .9 to 21 grazing hours (odds 2.1 times) but not with 3 to 9 h (odds 1.0 times) compared with zero-grazing. Lameness, hard cubicle surface and Danish Holstein v. other breeds showed an increasing effect on the probability for integument alterations. Increase in days in milk only showed an increasing effect on the probability for lesions and swellings. We concluded that a long daily stay on pasture is most beneficial for the hock joint integument of a dairy cow.