Abstract Pig survivability stands as a formidable challenge for the United States Swine Industry, constituting both the foremost economic hurdle and a prominent sustainability concern. The economic dimension of this challenge has been accentuated by escalating production costs driven by the surge in feed inputs, labor expenses, and other variable cost increments. Current estimations of birth-to-market survivability, ranging from 60% to 85%, underscore the urgency of addressing this multifaceted issue, with sow livability varying from 70% to 90%, contingent upon the data source and housing system (e.g., Prop-12, Open Pen Gestation; Ross et al., 2019). This presentation delves into the intricate web of factors contributing to the decline in survivability, encompassing genetic influences, heightened disease pressures, biosecurity concerns linked to pig density, evolving management practices, and the aging infrastructure of facilities. While extensive research has been dedicated to each of these facets, advancements in swine survivability remain constrained, with some indicators suggesting a troubling increase in challenges. The presentation seeks to offer a comprehensive review of the current state of swine industry survivability, elucidating the persistent challenges and, crucially, identifying untapped areas of opportunity. By navigating through the complex landscape of economic constraints, environmental considerations, and technological interventions, the symposium aims to provide insights that can guide the industry towards innovative solutions, fostering a more resilient and sustainable future for the United States Swine Industry.