The study aim was to characterise issues faced by farmers and veterinary surgeons when making end-of-life decisions for dairy cattle. Online surveys were distributed to British dairy farmers and veterinary surgeons for 20weeks from November 2020. There were 83 responses (37 farmers, 46 veterinary surgeons). Among youngstock, the risk of unassisted/natural death (2.6% ± 0.3%) was almost double the risk of euthanasia (1.4% ± 0.3%; p = 0.003). The opposite, however, was true in the milking herd: the risk of euthanasia (2.3% ± 0.3%) was greater than unassisted/natural death (1.6% ± 0.2%; p = 0.05). A fallen stock collector (62%) typically performed euthanasia and most farms (66%) did not have anyone trained to perform euthanasia. Most deaths within the milking herd were attributed to 'unknown or not recorded' (median 15% of deaths). The factors that farmers most frequently reported as strongly influencing their decision of when to euthanase an animal relative to the onset of disease were 'failure to respond to treatment' (89%), 'veterinary advice' (89%) and 'severity of disease' (88%). On average, veterinarians had moderate or high confidence that 60% of dairy farm clients 'are performing euthanasia in a timely manner so as to prevent unnecessary suffering'. Veterinary surgeons had variable agreement on the time to euthanasia for various conditions. The survey highlighted end-of life decision-making successes and areas for improvement on dairy farms. An evidence-based, decision-support framework may help end-of-life decision-making, particularly for complex diseases.