Bovine paratuberculosis can be costly to farmers who, as a consequence, may be interested in control of the causative agent, Mycobacterium avium subsp. paratuberculosis (MAP). Between-herd spread is primarily due to movement of MAP-infected livestock, and within-herd transmission most often occurs when susceptible calves are exposed to the faeces of infectious adult cattle. This review provides an update on options to control MAP infections via the use of diagnostics, with an emphasis on dairy cattle. Control of MAP infections can be achieved through improved hygienic measures and reducing the exposure of susceptible animals to the milk and faeces of infected animals. However, cost-effectiveness may depend on labour costs, and strategic use of diagnostics may have certain appeals through the information provided. Current bulk tank milk tests are not deemed to have a role in MAP control, whereas other herd-level diagnostics can be useful to guide establishment of control schemes by estimating whether MAP infections are prevalent or not. Then, test strategies based on screenings using cow-level tests can be used to identify the majority of infectious animals. The proportion of detected infectious animals depends on the timing of testing. If test results are used for risk-based management, then it is of utmost importance that they are still valid when used. Test results 3–6 months old may have lost a significant part of their validity. However, more research on the validity of test results over time to determine the infectiousness of animals should be carried out to enable the design of better test strategies.