Dairy production plays an important role in the lives of many people in Rwanda and Nepal. The aim of the Feed the Future Innovation Lab for Livestock Systems (LSIL; Gainesville, FL) is to introduce new location-appropriate technologies and to improve management practices, skills, knowledge, capacity, and access to inputs across livestock value chains in developing countries such as Rwanda and Nepal. To assist LSIL, our first aim was to describe gaps in the management of cows and in milk processing that constrain milk quality and quantity in Rwanda and Nepal. Our second aim was to describe training-of-trainers workshops in both countries as an initial response to the findings from the first objective. We conducted literature reviews and did rapid needs assessments in both countries. The literature reviews revealed similar aspects of the challenges of smallholder crop-livestock mixed farming systems in both countries. Many farms are struggling with feed quality, reproduction, and health of dairy cows. Milk production per cow and quality is often low. Fresh milk is collected by milk collection and cooling centers. Hygiene and milk processing capability and shelf life of products can be improved. Local rapid needs assessments were conducted in 2016 (Rwanda) and 2017 (Nepal) through visits to farms, milk collection and chilling centers, and processing plants, and through discussions with local dairy officials. The assessments supplemented and completed our understanding of stakeholders' needs in management and processing of milk. Limiting factors to improving the productivity, quality, and safety of milk in Rwanda and Nepal were a combination of sometimes limited knowledge in areas such as feeding, mastitis control, and hygiene, and a lack of access to resources such as quality feeds, transportation, and cooling that hindered implementation of existing knowledge. Training-of-trainers workshops in milk processing and hygiene were developed and given in Rwanda and Nepal based on the rapid needs assessments, and these were well received. We concluded that Rwanda and Nepal both have smallholder dairy farms that often face similar challenges such as lack of quality feeds, needs for basic dairy management education, low cattle productivity, and undesirable milk quality. Training-of-trainers programs to address these basic issues may be successful. Continued improvements in the dairy value chain depend on available resources for education.