Ginning practices affect both economic returns to cotton producers and quality of fiber produced for textile mills and, ultimately, consumers. Because of the shift from a primarily domestic to an export market for U.S. cotton and the loss of textile market share to synthetic fibers, production of high-quality cotton is critical to maintaining the competitiveness of the U.S. cotton industry. The objectives of this review are to summarize the effects of ginning on cotton quality, focusing on recent research, and provide best practices for gin managers to maximize bale value and fiber quality. Higher fiber moisture content at the gin stand, with an optimum of 6 to 7%, better preserves fiber length and strength, but this moisture level reduces both seed cotton and lint cleaning efficiency; therefore, a fiber moisture content of 5 to 6% might be needed for efficient cleaning. Seed cotton cleaners are effective at removing larger foreign matter particles and cause minimal fiber damage. Lint cleaners are efficient cleaners and necessary for removing seed-coat fragments and other small particles created in the gin stand. However, lint cleaners break some fibers, create neps, and remove some good quality fiber. To maximize fiber quality, gins should encourage producers to grow high-quality cultivars and follow recommended harvesting practices. Modules need to be stored and handled properly. Gins should use the minimum amount of drying and lint cleaning that maximizes bale value. Avoiding contamination is vitally important to uphold the U.S. cotton industry’s reputation as a supplier of high-quality cotton.