Passive immunity mediated by colostrum is essential for the immunological development of calves during the first hours of life, and its efficiency depends on maternal, neonatal, environmental, and management-related factors. The aim of this study was to evaluate maternal, colostrum management, and environmental factors associated with the presence of clinical signs compatible with neonatal disease in calves from farms in Yolombó, Antioquia, Colombia, with a One Health approach. An observational cross-sectional pilot study was conducted on six cattle farms. A structured survey collected information on maternal, neonatal, colostrum management, environmental, and sanitary variables. Data were analyzed using descriptive statistics and Fisher's exact test (p ≤ 0.05). Fifty percent of the evaluated cows were multiparous and 16.7% experienced dystocia. No farm reported prepartum vaccination. Among neonates, 66.7% exhibited high vitality while 33.3% showed clinical signs compatible with neonatal disease. All calves received colostrum within the first four hours postpartum. Farmers do not assess colostrum quality using diagnostic techniques. According to the farm records, Cryptosporidium spp. (50%) and Eimeria spp. (33%) were the most frequently recorded enteric agents. However, it is important to note that the presence of these pathogens was not confirmed in this study. Additionally, 66.7% of farms presented muddy conditions and low environmental temperatures. No significant associations were observed between the evaluated variables and neonatal clinical signs; however, given the pilot nature of this study (n = 6 calves), these results should be interpreted with caution due to limited statistical power. The One Health framework enabled interpretation of the interaction among the analyzed factors; nonetheless, the absence of direct human health indicators presents a limitation; future studies should incorporate zoonotic risk assessment among farm workers. We provide relevant information on bovine neonatal health practices in the region, and this serves as a basis for future research involving a greater number of farms, cattle, and regions in Colombia.