There is a pressing need for the judicious use of antibiotics in food animals to reduce the risk of antimicrobial resistance in pathogens of importance to human health. Selective dry cow therapy (SDCT) refers to the treatment with long-acting antimicrobials of only cows or quarters identified with or at risk of having an intramammary infection at dry-off, or at risk of acquiring one during the dry period. Conversely, blanket dry cow therapy (BDCT) consists in the treatment of every quarter of every cow at dry off. BDCT has been widely adopted in the last decades and led to an important success in the reduction of contagious mastitis. However, recent studies report a low prevalence of intramammary infections at dry-off in many herds. This, in addition to the recent introduction of rapid on-farm diagnostic tests, and the availability of teat sealants, may allow development of successful SDCT strategies. Although the number of clinical trials with adequate internal validity evaluating the efficacy of SDCT is limited; it appears that farm selection is key for the success of SDCT strategies. Bulk tank SCC, as well as intramammary infection prevalence and etiology at dry off have been used to select herds benefiting from SDCT. Thereafter, the accurate identification of cows or quarters benefiting from antimicrobial treatment is the cornerstone for the implementation of SDCT. Strategies followed vary from use of cow records (e.g., SCC records, clinical mastitis history), culture results, cow-side diagnostic test results (California Mastitis Test, milk leukocyte differential count, etc), or a combination of them. The economic returns of SDCT include savings on antibiotics and milk withholding after parturition. However, even with no differences in health or performance for not treated cows or quarters, there are associated diagnostics and labor costs. In conclusion, the current epidemiology of mastitis in addition to the availability of new technologies make SDCT a logical step to reduce antibiotic use in dairy cows. However, there is still a need to large multi-herd randomized controlled studies to investigate whether SDCT programs will be effective under diverse management conditions.