In the last decade the main goals of organic dairying have been to attain acceptable levels of milk production, increase opportunities for animals to perform species own behaviour, resulting in improved animal welfare and animal health, and minimize the use of therapeutic interventions, including the reduction of the (preventive) use of antibiotics. Maintaining animal health without the use of therapeutic interventions is a major challenge for organic dairy farmers. In particular, udder health remains a major problem in both conventional and organic farming. In the QualityLowInputFood (QLIF) project udder health status and management were assessed in different production systems and European regions. These studies suggest that good udder health can be maintained in organic or low-input farming management systems. Novel strategies to control mastitis were evaluated and the potential of using internal teat sealers for the control of environment-associated pathogens was shown. Also oral application of a herd profile based single homeopathic remedy combined with homeopathic silica had a significant effect on cows with a relative low somatic cell count before drying-off. Suckling systems in calf rearing, as an integrated management approach, did not result in better udder health. None of the studies presented identified new variables affecting udder health. QLIF studies also demonstrated the importance of comparing udder health parameters in contrasting organic, low input and conventional production systems, since clear differences in antibiotic use against mastitis could be identified not only between organic and conventional systems, but also among dairy systems used in different EU-countries. Although alternative treatments used in organic systems could not be shown to be fully effective, results suggest that the use of individual or combined alternative strategies to improve udder health on organic or low-input farms warrants further investigation. Based on the results obtained it is recommended that future research should focus on identifying the reasons for variability in udder health between organic farms that use different management protocols to identify ‘best current practice’ when carrying out this research.