Mycobacterium avium subspecies paratuberculosis is the causative agent of paratuberculosis in cattle which causes a chronic infection of the small intestine. Since the transmission is only partly understood current control programs have been able to only decrease prevalence but not to eradicate disease from a herd. Unknown and therefore uncontrolled routes of transmission were suggested and infective bioaerosols were hypothesized as a potential candidate. This review gives an overview concerning disease transmission and focuses on consequences of bioaerosols on the within-herd transmission of paratuberculosis.