Foot and claw disorders are, along with reproductive and udder health problems, major reasons for involuntary culling in dairy cattle. Culling due to lameness accounts for 8-15% of all culls. This chapter describes the key factors needed to achieve genetic improvement of claw health and discusses the challenges. It covers the various steps in breeding from the definition of the breeding goal, performance recording (phenotyping) with standardization and measures to improve data quality, genetic evaluation with the genetic background of traits, trait definitions, data validation and models, including aspects of genomic evaluation, direct and indirect selection for claw health and the possible impact on genetic gain. The chapter provides examples of successful implementation into routine breeding programmes and offers recommendations and examples of best practice. Finally, the chapter looks ahead to future research trends in this area and makes suggestions for further reading on the subject.