The livestock sector in Low and Middle Income Countries (LMICs) is evolving. In response to growing demand for livestock products, it is likely that smallholder production systems will experience varying forms of intensification. Associated decision making is made complex, not only with the intrinsic characteristics of livestock in LMICs (for instance as sources of income, assets, or social symbols), but also by diverse objectives of stakeholders and agricultural development paradigms. This paper discusses trade-offs that are likely to arise in the choice of livestock production systems; with a focus at household and farm level, economic gains, gender equity, environmental concerns, human nutrition and food safety are all considered. We begin by describing trajectories of livestock intensification in LMICs. Then potential trade-offs during such intensification are depicted; with examples concerning environmental, economic and social aspects. Recognising and understanding trade-offs is imperative; therefore we discuss decision making methods, the management of trade-offs and the balance between providing an average benefit for a population and the variation in benefit for individuals. Finally, a (partial) trade-off analysis is illustrated by use of a case study on household dairy cattle enterprises in Senegal. The discussion advocates for holistic approaches to agricultural development efforts, which include recognition of the multiple objectives and the associated trade-offs.