Working with livestock is a hazardous activity, and animals have been found to be the most frequent injury source on dairy farms. Understanding the risk factors for injury and the causal relationships related to injuries and animal handling is important for developing prevention strategies and effective safety interventions. This study examined stress and handler attitude as possible risk factors for animal handling injuries in dairy farming, in particular when moving cows. Twelve dairy farms were visited on two occasions representing different stress levels: when cows were being moved to milking (low stress) and to hoof trimming (high stress). Behavioral observations of handlers and cows were performed, and questionnaires were completed on attitudes (risk acceptance, safety locus of control, and attitudes toward cows) and stress (perceived stress/energy level and job strain). The injury risks were found to be higher when moving cows to hoof trimming compared with moving cows to milking and gentle, moderately forceful, and forceful interactions were more frequently used. When moving cows to milking, observed risk situations were related only to the perceived energy level of the handler. When moving cows to hoof trimming, injury risks were correlated to job strain and time spent in the risk zone (defined as the area where the handler could be hit by the cow's head or hind legs). The time spent in the risk zone was positively correlated with job strain, age, and experience. Attitudes were not found to have significant impact on safety but were to some extent indirectly involved. These results suggest that the main focus in injury reduction work should be on reducing the time the handler spends in close proximity to animals during aversive procedures and on minimizing cow fear and stress by proper handling techniques and appropriate design of handling facilities.