Conventional cotton production has been associated with the extensive use of agricultural chemicals, leading to environmental and health problems, decreased effectiveness of pesticides and higher costs of production. Organic bans the use of most pesticides while providing premiums for growers, and therefore may be a beneficial alternative for growers. Unfortunately, there has been a paucity of research examining the specific practices used by organic cotton growers and the environmental aspects of those practices. This study surveyed organic cotton producers and processors to document specific approaches and techniques used in organic cotton production and processing, the environmental impacts of those techniques and challenges facing organic cotton growers. We discuss the environmental impacts of organic management techniques and methods for conserving water and reducing dependence on irrigation. We also highlight the challenges to organic production identified in the survey, including management for weeds, insects and diseases, genetic contamination of organic crops from genetically modified cotton, organic seed availability, climate change, chemical drift and marketing of organic cotton. Finally, we suggest that investing in research to produce higher-yielding organic varieties, improved methods for organic weed management, and supporting carbon-sequestering practices will improve conversion to organic production.