Hazelnut skin (HS) was evaluated as a source of nutrients for dairy cows. In total, 26 Aosta Red Pied cows were divided into two balanced groups. All cows were fed hay ad libitum. The control group was also given 6 kg of concentrate, while the hazelnut skin group (HAZ) was given 1 kg of the same concentrate that was substituted by 1 kg of HS. The dry matter intake of the cows was reduced by the dietary inclusion of HS (p ≤ 0.001). The milk yield and main constituents were unaffected by treatment. Milk from HAZ cows showed decreased concentrations of de novo saturated fatty acids (FAs), odd- and branched-chain FA, α-linolenic acid, and long-chain n-3 FAs, as well as increased concentrations of stearic acid, oleic acid, linoleic acid, total monounsaturated FAs, trans biohydrogenation intermediates, and α-tocopherol. Replacing the concentrate with HS increased the human-inedible feed quota in the diet and improved the sustainability of milk production in terms of the food-feed competition. Our results suggest that it is possible to add economic value to organic waste from the hazelnut industry using HS as a feed ingredient for dairy cows, enhancing the feed efficiency and milk antioxidant activity and having expected impacts on the nutraceutical quality of milk fat.