Interventions aimed at improving animal welfare on farms may be more successful if greater attention is paid to the points of view of farmers. For example, understanding how different dairy farmers detect lame cows, decide to treat them, get them to the point of treatment, and how practical considerations that impact on this process may be important for reducing lameness on dairy farms. In-depth interviews with twelve dairy farmers were carried out to explore how this occurred on their farms. This in-depth approach allowed a number of factors influencing lameness treatment to be uncovered. The language used by farmers to describe lameness gave important insight into their perceptions of lameness and into the value they placed on prompt treatment. Farmers’ perceptions of lameness were found to affect the speed of treatment, with treatment of cows perceived to have impaired mobility or to be less severely lame sometimes delayed. Other priorities on the farm, skilled labour availability, farm infrastructure and farmers’ emotional responses to lameness treatment were all found to impact on whether or when a lame cow was treated. In order to encourage farmers to promptly treat all lame cows their perceptions of lameness and the benefits of prompt treatment must be addressed. The language used when communicating with farmers about lameness may be key to achieving this. The practical barriers, such as time and labour constraints, associated with the treatment process, must also be understood, taken into account and seen in the context of the farm management as a whole.