As milk production has increased during the past four decades, conception rates in lactating cows have declined. Although reduced reproductive performance has been associated with high milk yields, measures of postpartum ovarian activity have been more closely related to energy balance. The relationship between daily energy balance and postpartum reproductive activity is confirmed by longer intervals to first ovulation in cows with greater body condition loss. Patterns in daily energy balance, such as improvement from nadir, have been correlated with enhanced follicular function and a shorter interval to first ovulation. Such observations are consistent with increased LH pulse frequency following the energy balance nadir in lactating dairy cows. Evidence indicates a primarily hypothalamic locus for the modulation of LH secretion during negative energy balance. Formation of follicular waves after parturition begins synchronously in response to increased FSH in the first week postpartum, and is typically not a limiting factor in reproductive recrudescence. Altered follicular responsiveness to gonadotrophic support through changes in metabolic hormones such as insulin-like growth factor I (IGF-I) and insulin may contribute to impaired function of dominant follicles early postpartum. Positive relationships between changes in energy balance, peripheral IGF-I and function of dominant follicles support the identification of IGF-I and the day of the energy balance nadir as metabolic modulators of postpartum ovarian activity in dairy cows.