As the organic dairy farming sector grows across Europe, it is necessary to continuously review its various merits and challenges within the organic sector and in comparison with conventional farming methods. Drawing together empirical findings from across the Europe, this chapter summarises some of the major issues surrounding organic dairy farming, such as the effects on herd health, regulations around pasture access and different methods of calf rearing. It then considers a number of current ‘hot topics’ in this area, including the self-sufficiency of concentrated feeds and the effect of organic methods on udder health. The chapter concludes that organic dairy farming presents many potential benefits, but notes that improvements are necessary, particularly in the area of animal health. It emphasises that solutions to current problems must be site-specific, while observing that particularly successful strategies could serve as helpful models in both organic and conventional dairy farms.