Monitoring udder health of a dairy herd has three functions: firstly describing the actual situation, secondly evaluating the efficiency of adopted improvement measures and treatments, thirdly to detect emerging problems as early as possible. Therefore, husbandry, feeding, and management of the cows haVeto be included in the surveillance. Risk-based monitoring of the udder health is characterized on the one hand by focussing on the currently relevant herd-specific risk factors. Consequently, it is a dynamic process. On the other hand, it is affected by a clearly structured approach to prevent a loss of control due to a lack of attention in any area. All essential decisions and actions are documented to be comprehensible and available for critical examination. This review explains the procedure to establish a risk-based monitoring program on dairy farms.