Lameness in sows is an animal welfare problem which also presents an economic challenge to pig producers. Information about the prevalence of herd lameness in organic sows is relatively scarce. The first objective of this study was to establish the prevalence of lameness and to identify risk factors associated with sow lameness in Danish outdoor organic sow herds by analysing the association between risk factors at both sow and herd level using clinical records of lameness. A total of 1850 sows from nine organic herds were included in the study. Second, the study examined differences in the prevalence of sow lameness between outdoor organic and indoor conventional herds. An additional aim here was to identify risk factors associated with clinical records of sow lameness in Danish sow herds by analysing the association between risk factors with lameness at sow and herd level. One thousand and fifty four gestation sows from 44 indoor conventional and nine organic sow herds were included in this study. The nine organic herds were visited twice: once in summer/autumn 2011, and once in winter/spring 2012. In winter/spring 2011, a total of 44 indoor conventional herds were visited. Risk factors included in the study were clinical parameters and factors related to the production system. Sows were examined visually by one of four trained observers. The organic sows were assigned scores for lameness, body condition, hoof length, bursitis, abscesses and leg wounds, while the conventional sows were assigned scores for lameness, body condition and bursitis. A multivariable analysis was carried out by logistic regression with the herd and observer as random effects. The average herd lameness prevalence in gestation and lactation sows in organic herds was 11% in summer/autumn and 4.6% in winter/spring. ‘Wounds, bursitis and abscess’ on legs (OR=4.7, P<0.001) and body condition score >3 (OR=1.79, P=0.008) were associated with increased risk of lameness in Danish organic sow herds. Season (winter/spring v. summer/autumn) lowered the risk of lameness (OR=0.37, P<0.001). Average prevalence of lameness in gestation sow herds in winter/spring in conventional herds was 24.4%, and in organic herds it was 5.4%. An organic sow had a decreased risk of lameness (OR=0.28, P<0.001) as compared with a conventional sow. Bursitis was associated with increased risk of lameness (OR=2.08, P=0.002) regardless of the production system (i.e. whether the herd was organic or conventional).