This research paper compares fertility traits, health indicators and health management routines of Swiss dairy farms characterized by short vs. long productive lifespans (SPL vs. LPL). We evaluated whether a longer productive lifespan will result in poorer cow health based on herdbook data from breeders associations (n = 142), farm questionnaire data (n = 67), veterinary treatment data (n = 64) and data obtained during farm visits (n = 30). Dairy farms were selected in such a way that they contrasted in terms of length of productive lifespan, but were representative of the Swiss dairy sector. Fertility performance was better on farms with LPL indicated by a lower number of inseminations per heifer, shorter average number of days open and shorter calving intervals. Consistently, the proportion of antibiotic veterinary treatments due to fertility problems was by tendency higher on SPL farms, as was the number of antibiotic treatments due to other problems (i.e. other than fertility, udder or locomotion problems). Other types of veterinary medical treatments did not differ by productive lifespan profiles. Average somatic cell score and proportions of test day records with elevated somatic cell count (SCC) were significantly higher on farms with LPL. However, this increase was smaller than what could be expected due to the age difference between contrasting productive lifespan profiles and was not associated with higher treatment incidences for clinical mastitis. Locomotion scores and lameness incidence did not differ by productive lifespan profile. Apart from a slightly higher proportion of farms with LPL practicing abrupt drying off, cow health management routines did not differ significantly between farms of contrasting productive lifespans. We conclude that a longer productive lifespan is not at the expense of health, even if the SCC level increased with age. Fertility, limb and udder health should be the main focus when aiming for a long productive lifespan.