This paper reviews the state of the art in offshore wind farm operations and maintenance with a focus on decision support models for the scheduling of maintenance. Factors influential to maintenance planning are collected from the literature and their inclusion in state-of-the-art models is discussed. Methods for modeling and optimization are presented. The methods currently used and possible alternatives are discussed. The existing models are already able to aid the decision-making process. They can be improved by applying more advanced mathematical methods, including uncertainties in the input, regarding more of the influential factors, and by collecting, analyzing, and subsequently using more accurate data.