The purpose of this study was to describe prevalence and spatial distribution of Coxiella burnetii infections in dairy cow sheds in Latvia and to investigate risk factors contributing to C. burnetii infections. Blood serum samples from abortion cases from 1010 sheds have been tested by ELISA for the presence of C. burnetii antibodies and bulk tank milk (BTM) samples from 252 sheds have been tested by real time polymerase chain reaction and ELISA for the presence of C. burnetii DNA and antibodies. Prevalence of C. burnetii antibody-positive sheds in cases of abortion was 13·4%. A total of 10·7% and 13·2% of dairy cow sheds tested positive for the presence of C. burnetii DNA and antibodies in BTM, respectively. Two distinct areas of clustering of test-positive dairy cattle sheds were identified by spatial scan statistics of abortion cases and randomly sampled BTM samples. Three factors were identified as significantly contributing to the risk of C. burnetii DNA presence in BTM – number of cattle in shed (>200 animals/shed) (OR 3·93), location of the shed within risk area in Northern Latvia (OR 8·29) and for the first time, purchasing cattle from abroad has been shown to significantly increase risk (OR 2·68) of C. burnetii infection in dairy cows in Latvia.