This ecological study aimed to associate hormone use for reproductive diseases and heat induction with reproductive performance at herd level. Hormone use, herd characteristics, and test-day recording data were obtained from 754 representative Dutch dairy farms belonging to five large veterinary practices from 2017 to 2019 (1679 observations in total). Hormone use was classified into prostaglandin, gonadotropin-releasing hormone (GnRH), and progesterone, and was expressed at herd level as the annual number of hormone doses per 100 adult dairy cows. Hormone use was categorized into four levels (no usage, low, medium, and high use), following the 33rd and 66th percentiles of herds that applied them. Three herd-level reproductive performance indicators (calving interval, calving-to-1st insemination interval, number of inseminations per cow) were analyzed using multivariable General Estimating Equations models. The median annual total hormone use was 36.1 (mean=43.1; min=0.0; max=248.2) doses per 100 adult dairy cows in all herds while the median was 39.2 (mean=46.8; min=0.4; max=248.2) doses per 100 adult dairy cows among the user-herds. The median annual group-specific hormone use was 21.3 (mean=26.1; min 0.0; max=180.0), 11.0 (mean=15.3; min=0.0; max=127.0) and 0.0 (mean=1.8; min=0.0; max=40.3) doses per 100 adult dairy cows for prostaglandin, GnRH, and progesterone, respectively. The final statistical models identified that herds with a high hormone use had a calving interval and a calving-to-1st insemination interval that was 9.3 ± 2.6 and 16.4 ± 2.1 days shorter than that of non-user herds (424.0 ± 2.7 and 114.0 ± 2.1 days), respectively. Furthermore, high-user herds needed on average 0.3 ± 0.04 inseminations more to get their cows pregnant compared to non-user herds (1.83 ± 0.04 no. of inseminations per cow). Medium-user herds had a 6.5 ± 2.6 days shorter calving interval and a 12.0 ± 2.1 days shorter calving-to-1st insemination interval with 0.2 ± 0.04 additional inseminations per cow compared to non-user ...