A review of the smallholder dairy production in Malawi was conducted using livestock annual reports and other literature that was supplemented with primary data from a baseline survey conducted in December 2009. Smallholder dairy farming in Malawi operates with support from institutions that facilitate access to initial stock and dairy production technologies. Most farmers (94%) keep the animals in pens where feed is provided throughout the year. Results indicated unsatisfactory feeding, housing and health management practices, which negatively impact cow fertility. Dairy population trends suggest low replacement rates, which could be associated to low cow fertility and inadequate management skills. There are challenges related to access to breeding and health services, which further contribute to low productivity. Low fertility is evidenced by low calving rates (22-61%) and long calving interval (405-549 days). Existence of programmes on farmer capacity building provides an opportunity for improved management skills and cow productivity. It is concluded that dairy cow management and fertility have challenges and opportunities that are influenced by the extent to which farmers have access to important services such as extension, health, breeding and finance.