The purpose of milking machines is to harvest milk at an optimum speed while maintaining cow comfort and preserving teat defence mechanisms against the invasion of mastitis pathogens, thus making machine settings critical in dairy herds. The various settings and combinations for milking machines were reviewed to enable operators to optimize them to preserve teat canal integrity and minimize mastitis. All databases of Web of Science and relevant websites were used to document machine settings and teat liners. All vacuum levels in milking systems need to be monitored. In addition, liners, milk yield, and automated cluster removal switch-point settings need to be regarded as bearing a risk of teat damage. They affect milking speed and vacuum levels at total, peak, and over-milking. An equilibrium should be reached between optimal milking speed and risk of teat damage. An increased switch-point setting shortens milking time and decreases overmilking and claw vacuum to preserve teat-canal integrity. Analysis of milk flow dynamics with a VaDia instrument highlights opportunities to improve milking protocols and equipment functions that align with the physiology of the cow. This knowledge can be applied on individual farms, in which herd milk yield, parlour layout, milking machine system, parlour management, and economics should be considered to obtain a balance between milking efficiency, udder health, and cow comfort. Standards for switch-point settings were identified in this review.