Cow's milk is currently the most consumed product worldwide. However, due to various direct and indirect contamination sources, different chemical and microbiological contaminants have been found in cow's milk. This review details the main contaminants found in cow's milk, referring to the sources of contamination and their impact on human health. A comparative approach highlights the poor efficacy and effects of the pasteurization process with other methods used in the treatment of cow's milk. Despite pasteurization and related techniques being the most widely applied to date, they have not demonstrated efficacy in eliminating contaminants. New technologies have appeared as alternative treatments to pasteurization. However, in addition to causing physicochemical changes in the raw material, their efficacy is not total in eliminating chemical contaminants, suggesting the need for new research to find a solution that contributes to improving food safety.