A herd of 373 milking cows was visited to have a farm evaluation performed due to a consistently high bulk tank (BT) milk somatic cell count (SCC) and high rates of clinical and subclinical mastitis. The BT SCC was approximately 300,000 cells/mL for at least eight months and the farm’s goal was to maintain a BT SCC < 150,000 cells/mL. A thorough farm audit was performed including records analysis, submission of milk cultures, assessment of milking routine and equipment, and evaluation of housing/bedding. Problems were identified with pen hygiene and bedding management, milking routine and milking equipment. No written standard operating procedures (SOP’s) for the milking routine, dry-off protocol or the identification/treatment of clinical mastitis existed on this farm. High risks for new mastitis infections, chronic infections and high-fresh cows were identified. Mastitis cure risk was also suboptimal. The economic significance of this problem, via loss of SCC premiums, production loss, culling and death associated with mastitis, and treatment of clinical mastitis were discussed with the producer. Several recommendations were made in an effort to improve milk quality, decrease the incidence rate of clinical mastitis and improve cow comfort and hygiene.