The aim of this paper is to discuss the potential consequences of modern dairy cattle breeding for the welfare of dairy cows. The paper focuses on so-called genomic selection, which deploys thousands of genetic markers to estimate breeding values. The discussion should help to structure the thoughts of breeders and other stakeholders on how to best make use of genomic breeding in the future. Intensive breeding has played a major role in securing dramatic increases in milk yield since the Second World War. Until recently, the main focus in dairy cattle breeding was on production traits, but during the past couple of decades more emphasis has been placed on a few rough, but useful, measures of traits relevant to cow welfare, including calving ease score and 'clinical disease or not'; the aim being to counteract the unfavourable genetic association with production traits. However, unfavourable genetic trends for metabolic, reproductive, claw and leg diseases indicate that these attempts have been insufficient. Today, novel genome-wide sequencing techniques are revolutionising dairy cattle breeding; these enable genetic changes to occur at least twice as rapidly as previously. While these new genomic tools are especially useful for traits relating to animal welfare that are difficult to improve using traditional breeding tools, they may also facilitate breeding schemes with reduced generation intervals carrying a higher risk of unwanted side-effects on animal welfare. In this paper, a number of potential risks are discussed, including detrimental genetic trends for non-measured welfare traits, the increased chance of spreading unfavourable mutations, reduced sharing of information arising from concerns over patents, and an increased monopoly within dairy cattle breeding that may make it less accountable to the concern of private farmers for the welfare of their animals. It is argued that there is a need to mobilise a wide range of stakeholders to monitor developments and maintain pressure on breeding companies so that they are aware of the need to take precautionary measures to avoid negative effects on animal welfare and to invest in breeding for increased animal welfare. Researchers are encouraged to further investigate the long-term effects of various breeding schemes that rely on genomic breeding values.