This study reports for the first time temporal trends for the period of 2011–2016 in 137Cs content in cow's milk originating from private farms and households of 14 settlements located in the territories of the Rivne region, Ukraine. These areas are still radioactively contaminated as a result of the accident at the Chernobyl Nuclear Power Plant (ChNPP) in 1986. In 2016, the average 137Cs activity concentration in milk exceeded the Ukrainian Permissible Level (PL) for adults of 100 Bq/l in samples from 6 settlements and the PL for children of 40 Bq/l in 8 settlements, reaching activity concentration of around 500 Bq/l in some samples. Estimated annual effective doses calculated utilizing two different methodologies were in the range of 1.4–2.6 mSv/year and 1.2–1.8 mSv/year, respectively. The estimated effective period of milk semi-purification (T 1/2 _ eff ) from 137Cs in these settlements was in the range from 8 to 17 years. The estimated ecological period of milk semi-purification (T 1/2 _ eco ) from 137Cs was in the range from 11 to 36 years. The optimization of the remedial actions strategy for investigated settlements exposed to an effective dose above 1 mSv/year (as estimated in 2016) has shown that a diversity of measures can decrease effective dose for a representative person to below 1 mSv/year. Such measures include application of Ferrocyn to cows, mineral fertilization of potato fields, information campaigns on consumption of wild mushrooms and other forestry products, and feeding pigs with uncontaminated fodder. The total costs of such measures are estimated to be about 71,000 Euro per year for the combined population (8336 inhabitants) of the six villages investigated in this study that showed the highest median residual 137Cs activity concentrations in milk, with a subsequent decrease in cost in the future. This would result in an averted collective dose of 11 man-Sv, at an average cost of 6.5 kEuro/man-Sv averted. In the absence of governmental programs for implementation of necessary protective measures to reduce radiological risks to impacted populations, the exceedance of PL for the activity concentration of 137Cs in cow's milk for adults of 100 Bq/l in the Chernobyl-affected areas of Ukraine could persist for many more years – until at least 2040.