Pasture-based dairy systems are implemented all over the world. Access to pasture is perceived to be advantageous for animal welfare in western societies. However, the benefits of grazing on lameness are not uniformly verifiable. This is related to the challenges that grazing cows face which are different from zero-grazing systems to some extent, but may nevertheless be deleterious. The distribution of lesion types comparing housed and pastured cattle differs between studies. This may be caused by differences in how strongly certain risk factors apply in these studies. Major risk factors for lameness in grazing cattle are related to the risk of trauma, for example from long walking distances and lack of track maintenance, and cow factors such as the adaptability of certain breeds to the grazing lifestyle. The consequences of lameness are similar to zero-grazing cattle and negatively affect animal welfare and productivity.