Milk is one of the world’s most economically important agricultural commodities. Milk production is growing worldwide, and further growth of 1.8 % per year is expected until 2034. In the Czech Republic, too, the total supply of milk is increasing due to the growth in average cow milk yield. Achieving good economic results is a prerequisite for maintaining production and self-sufficiency in milk production. A frequently evaluated indicator in agricultural enterprises is cost profitability, measured by the ratio between profit and production costs. According to a cost survey conducted by the Institute of Animal Science, the average cost for a group of 86 to 143 dairy farms was 9.26 CZK per liter of milk sold in the ten-year period from 2015 to 2024. The average purchase price of milk was almost the same (9.27 CZK per liter), which means that the long-term profit was almost zero. The average profitability in the analysed period fluctuated between -19 % (2016) and +13% (2022), with great variability between farms. Profitability was significantly influenced by the level of productivity and the breed of dairy cows. The economics of breeding are influenced by a number of factors, one of which is the health of the cows. In most herds, a large proportion of cows are culled for health reasons, with mastitis and limb diseases being the most common. The total annual costs per sick cow for 2024 in the Czech Republic were estimated at an average of 12,000 CZK for mastitis and 10,000 CZK for limb disease.