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This study evaluated the use of microbiological culture of milk from cows with clinical mastitis (CM), and the performance and economic results after implementing this procedure. The 18-month data were obtained from a farm in Minas Gerais State, Brazil, with an average daily production of 23.1 L of milk from cows milked twice daily under a semi-intensive regime. After a case of CM was identified, a milk sample from the affected quarter was collected and sent to the farm's laboratory. First, a bi-plate containing selective growth medium was used for isolation of Gram-positive and negative bacteria (Plate 1). Subsequently, a tri-plate with selective growth medium was used for isolation of Gram-positive and negative bacteria, and bacteria of the genus Streptococcus (Plate 2). Finally, a tri-plate containing three chromogenic culture media capable of identifying 18 bacterial species was used (Plate 3). Clinical cases of mastitis were treated once a day based on the results of the microbiological culture. Two economic scenarios were evaluated (scenarios 1 and 2). Scenario 1 compared the situation if all cases of CM were treated (not using on-farm culture) vs. the use of on-farm culture (real data) and the generated savings for one year. Data from 1,582 lactations of 1,227 cows were evaluated, with 1,917 cases of CM from 636 cows recorded. The average annual incidence of CM was 48.2%. Of all cases evaluated, 76.8% were classified as grade 1 mastitis; 20% as grade 2, and 3.2% as grade 3. The incidence of new clinical cases of mastitis was 4.17% per month. From the samples analyzed on the three plates, 27.8% of the cases received a recommendation to not be treated and 72.2% received a recommendation of treatment. However, only 18.6% were not treated, making a total of 81.4% treated cases. Of the clinical cases that did not receive intramammary antibiotic therapy, 84.3% had a clinical cure. Conversely, the clinical cure rate reached 84% for the cases that received intramammary antibiotic therapy. In scenario 1, the total operational cost of the clinical case decreased by 10.3% after the implementation of the on-farm culture, with an 18.4% reduction in the use of antibiotics. In scenario 2, there was a 5.5% reduction in the cost of the clinical case and an 11.8% reduction in the use of antibiotics. Thus, the implementation of on-farm culture and the applied methodology, enhanced treatment accuracy of CM cases, reducing the total operating cost of the case and the use of antibiotics on the farm. [ABSTRACT FROM AUTHOR]