A qualitative research study was conducted to describe and analyze farmers' perspectives on their own choices regarding decisions to have cows treated for mastitis. Through qualitative research interviews of 16 Danish dairy farmers, four levels of the decision-making process used by farmers to decide whether or not to treat a cow with antibiotics were identified. Those levels were: 1) symptom level (seriousness of the mastitis case), 2) cow level (to the extent a cow fulfilled goals of the farmer and the herd), 3) herd level (the situation of the herd, e.g., in relation to milk quota), and 4) level of alternatives (whether the farmer regards such practices as blinding of teats or homoeopathy as serious alternatives to antibiotic treatment). All four levels could be recognized in all herds, but with differing weights and relative importance across herds. Directions of different possibilities within each level also varied among farmers. By identifying those four levels, a model for understanding the farmers' choices is provided. This provides background for dialogue with each farmer about choices in the context of each specific herd. It also provides insight into implications of mastitis treatments for effective treatment versus issues of antibiotic resistance when discussing choices on a more general level. Communication and understanding between farmers and their veterinarians and cattle-oriented advisors is essential. Farmers were shown to be coherent in their choices of treatment, but their decisions often seemed to differ from normal veterinary recommendations. Such differences have to be understood and implemented into effective decisions for the whole farm.