Since the introduction of the standard mastitis prevention program in the late 1960s, enormous progress has been made in decreasing the average bulk milk somatic cell count (BMSCC). In many countries, reduction of BMSCC has been encouraged through premium payments or penalty systems. However, the success of the program depends heavily on consistent implementation of management practices. The approach to problem solving in a herd with high BMSCC must include the following elements: (1) problem definition using primary udder health parameters; (2) detection of cows causing the problem; (3) definition of short- and long-term goals; (4) formulation and implementation of a herd management plan; and (5) evaluation of the results. Findings and plans are recorded for use at follow-up visits. Every high BMSCC problem can be solved if farmers are sufficiently motivated, if farm advisors are sufficiently knowledgeable, and if farmer and advisors work together according to a jointly determined plan.