Milking a cow causes stress to the teats and damage that is normal, but that can become severe due to variations in cow genetics, management, and equipment. Problems with the teats can be assessed through teat conditioning and may be the result of regular milking or faulty equipment. One alteration of the teat due to milking is hyperkeratosis, which is a thickening of the skin that lines the teat canal, characterized by excessive keratin growth. This excessive growth leaves an area for bacteria to hide and breed, which cannot be sanitized, and increases the risk of mastitis or intramammary infections (IMIs). The severity of the hyperkeratosis is drastically increased due to milking equipment factors. Duration of milking or over-milking, milk flow rate, liner closed phase, vacuum level and the amount of time the cups are on the teats all contribute to hyperkeratosis. The total time that the milk flow rate is less than 1.0 kg/min per day is the main contributing factor to hyperkeratosis severity. Faulty milking equipment has the potential to further exacerbate issues with hyperkeratosis by exposing the teat end to a higher number of bacteria than normal. Once present, these IMIs decrease producer profits by reducing total milk production, increasing somatic cell counts, treatments, cull rates, and milk lost due to treated cows. Although average somatic cell count (SCC) has fallen in herds over the past 20 year, national estimates still cite a to $300 per cow per year loss to elevated SCC. Comprehensive teat assessment and milking equipment checks are an effective way to help minimize incidences of hyperkeratosis. Understanding how and when to do both may help producers to reduce profit loss to IMIs as a result of hyperkeratosis due to milking equipment.