Sustainable milk production systems require economically viable, environmentally sound and socially acceptable practices. This study compared the economic, environmental and societal impact of large-scale farms with other dairy farms in the Dutch Farm Accountancy Data Network (FADN). Moreover the integrated sustainable performance of large-scale dairy farms was explored. To quantify the impact of farm size on economic performance, we used net farm income (NFI), labour productivity and solvency. We quantified environmental performance using indicators on non-renewable energy use, greenhouse gas (ghg) emissions, phosphorus surplus and pesticides use. To quantify societal performance, we used indicators on milk quality, cow lifetime and grazing hours. Large-scale dairy farms had a higher labour productivity and NFI than other dairy farms, without compromising on phosphorus surplus, energy use or ghg emission. Higher profits were accompanied by a lower solvency ratio on large-scale farms. Pesticides use, however, was higher on large-scale dairy farms due to a lower share of grassland. Large-scale farms had a shorter cow lifetime and applied less grazing compared to other dairy farms.