Mycobacterium paratuberculosis commonly infects dairy cattle, leading to Johne's disease, which is also known as paratuberculosis. The infection is chronic progressive, and incurable. As the infection progresses, excretion of M. paratuberculosis in feces and milk occurs, and the bacterium spreads through the blood to multiple internal organs. Consequently, raw products originating from cattle may harbor M. paratuberculosis. Thermal treatments, such as pasteurization, are commonly relied on to kill food-borne bacterial pathogens that can infect humans. The small number of studies conducted to determine the thermal resistance of M. paratuberculosis suggest that it is less susceptible to destruction by heat killing than are milkborne zoonotic bacterial pathogens such as Listeria spp. or Mycobacterium bovis. Published reports concerning the thermal resistance of M. paratuberculosis in milk are reviewed herein, and key issues concerning the efficacy of pasteurization for elimination of M. paratuberculosis from milk are summarized.