The clinical findings in 59 cows with bovine spongiform encephalopathy (BSE) were compared with those in 19 cattle that were submitted as BSE suspects but not confirmed by immunohistochemistry. Both groups were also compared with a control group of 20 healthy cows. Abnormalities in behaviour, temperament, mental status and activity, neurogenic disorders of gait and hyperreactivity to touch were frequently observed in the cattle with BSE. Not every animal with BSE displayed clinical signs in all these categories, and the severity of the signs was not always useful for differentiating them from the BSE suspects that were not confirmed by pathology. The neurological examination was better than passive observations for the clinical diagnosis of BSE. Tests of the animals' responses to sudden auditory, visual and tactile stimuli were very useful for distinguishing cases of BSE from unconfirmed BSE suspects if the cases did not display signs in all the categories.