Maintaining and promoting animal health and welfare are important but challenging goals in livestock farming. Animal health and welfare planning aims to contribute to improvements in the herd through interventions in a structured way. This review provides an overview of current scientific approaches to and improvements achieved by health and welfare planning in dairy herds regarding the health and welfare state of the cows, economic effects, and non-monetary benefits to farmers. Implementation of changes in management and housing is based on an assessment of the health and welfare state and relies on the participation of all involved persons. Farm-specific measures of management and housing, high levels of compliance with those measures, continuous review, and prompt adaptation are decisive. Improvements in health and welfare following the use of planning have been shown by several on-farm studies, especially in the context of mastitis and lameness. Studies on health and welfare planning that consider a more comprehensive view of welfare are scarce and the limited evidence available indicates that improvements may be less likely to be achieved. Apart from health and welfare benefits for the animals, economic and non-monetary benefits for the farmers are equally important. Costs of diseases and impaired health are available, while costs and benefits of interventions have been estimated with regard to mastitis and lameness only. Non-monetary factors (eg job satisfaction) have been reported as motivating factors for farmers but have attracted little scientific interest. Further research should focus on welfare aspects that go beyond the most important production diseases and the economic and non-monetary benefits of improving health and welfare in dairy cattle.