Paratuberculosis is a chronic granulomatous infection caused by Mycobacterium avium subsp. paratuberculosis (MAP) that affects multiple ruminant species causing important economic losses. Therefore, control programmes at herd and regional levels have been established worldwide and prevalence estimates are needed for their implementation. Although different herd-level prevalence estimations for paratuberculosis have been reported in Europe, very few studies provided comparable and interpretable values, due to poor study designs and lack of knowledge about the accuracy of the diagnostic tests used. To overcome these problems we applied a latent class analysis to the results of two prevalence studies carried out in two neighbouring Northern Italian regions (Lombardy and Veneto) that account for over 50% of the Italian dairy cattle population. Serum samples from a randomly selected number of farms in the two regions were analyzed by different ELISA tests. The herd-level Apparent Prevalences (AP) were 48% (190/391) for Lombardy and 65% (272/419) for Veneto. Median within-herd APs were 2.6% and 4.0% for Lombardy and Veneto, respectively. Posterior estimates for the herd-level True Prevalences (TP) based on a Bayesian model were very similar between the two regions (70% for Lombardy and 71% for Veneto) and close to previous estimates of infected herds in Europe. The two 95% credibility intervals overlap each other, virtually showing only one distribution of the herd-level true prevalence for both regions. On the contrary, estimates of the within-herd TP distributions differed between the two regions (mean values: 6.7% for Lombardy and 14.3% for Veneto), possibly due to the different age distribution within the herds from the two regions.