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Attitudes and empathy of farmers influence human–animal interaction, thereby affecting their behavior toward animals. The goal was to investigate how measures of attitude and empathy toward animals were associated with animal welfare indicators such as milk yield, mastitis incidence, fertility index, and the prevalence of skin lesions on cows. To assess empathy toward animals, a photo-based pain assessment instrument was developed depicting various conditions that could be associated with some degree of pain in cattle and included questions aimed at assessing attitudes toward animals. Photos of painful conditions are useful in eliciting measurable empathic responses to pain in humans. A total of 221 farmers were sampled via e-mail and 154 responses were obtained. In the first analysis, farmers were categorized into 2 groups according to their agreement or disagreement with the attitude statement “animals experience physical pain as humans do.” In the second analysis, farmers were assigned a median pain assessment score obtained from their estimates on the visual analog scale of 21 conditions assumed painful for cattle. In the third analysis, farmers were clustered in 3 groups according to their visual analog scale responses. Three conditions were ranked as the most painful: fracture of tuber coxae, dystocia, and serious mastitis. Farmers with positive attitudes toward animals scored 2 points higher on their empathy score compared with farmers with negative attitudes. Personal experience with each additional condition resulted in a 0.09 higher score. Cluster analysis revealed 3 groups. Farmers in group 3 had the highest median pain assessment score (6.7 ± 0.2), indicating a high level of empathy and a positive attitude toward animals. They had the lowest prevalence of skin lesions over the carpus (24 ± 6%) and the lowest milk production (6,705 ± 202 kg). The complex associations between indicators of empathy and attitudes with relevant welfare outcomes suggest that competence building to safeguard animal welfare could benefit from including both attitudes and empathy in human–animal interactions studies.