The dairy industry in Tennessee faces challenges with fluid milk oversupply, lower prices, and dairy farms struggling to survive. While many challenges revolve around supply, an overall decline in consumption of fluid milk is also occurring. Many states, including Tennessee, have pushed for a marketing shift toward local milk and dairy products in an effort to increase product demand and farm revenue. This project was focused on understanding the underlying reasons for these trends. The primary study objective was to understand consumer preferences and willingness to pay for local, organic, generic brand, and fluid milk in general. A secondary study objective was to understand consumer perceptions on milk production, safety, health, and retail markets. This study occurred from January 29 to February 2, 2019, in the form of a survey to elicit information on consumer preferences, milk preferences, local choices for dairy, health, and purchaser demographics. A 42-question survey was disseminated through Qualtrics, returning 440 completed surveys. The FREQ procedure of SAS 9.4 was used to assess consumer responses. All respondents resided in Tennessee. Mean age was 42 ± 15 yr with 81% being female. Price (35%), taste (31%), and expiration date (26%) were considered the first, second, and third most important considerations when purchasing milk. This was further reflected in the price consumers were willing to pay for generic ($3.20 ± 1.00), local ($4.20 ± 1.60), or organic ($4.20 ± 3.60) branded milk. Respondents considered milk “local” if it was produced within the surrounding counties (32%) or within the state (25%). For the secondary objective, 77% of respondents indicated they knew nothing to some about cow’s milk. The majority of respondents used personal physicians or pediatricians (23%) and online articles (21%) to learn about milk. Milk safety was not a concern. Although a small price discrepancy existed between generic and specialty branded fluid milk, more research is needed on the economic consequences to dairy producers. Educating physicians and pediatricians could better reach consumer audiences and potentially increase milk purchases.