Lactose is of great industrial importance and its production includes the cooling crystallization from highly concentrated solutions. Monitoring the crystallization process is essential to ensure reproducible product quality. Photon density wave (PDW) spectroscopy enables in‐line monitoring of highly concentrated processes in liquid dispersions. It was applied to the determination of the solubility and nucleation points of lactose monohydrate in water, sizing of lactose crystals, and to dissolution as well as crystallization monitoring. Other process analytical technologies (focused‐beam reflectance measurement, particle vision and measurement) were used as reference, and the comparison indicates that PDW spectroscopy is very robust against probe fouling and is, thus, a useful tool for monitoring crystallization processes in concentrated suspensions.