Abstract Ideal conditioned sows are desired because they maximize herd performance, improve female well-being, and optimize financial outcomes. Sow productivity has increased, and body composition of females has changed, with sows being leaner and having less adipose tissue compared with their predecessors. Our objective was to determine the relationship between sow caliper measurements with sow reproductive performance and longevity in the herd. Data collected in four different production systems located in the US and Brazil were used, with 3,083, 356, 7,456, and 26,773 individual PIC Camborough observations represented within each of these databases. Caliper measurements were collected at due to farrow and weaned sows and were recorded in units, standardized to an ideal range of 12 to 15 units. Caliper change in lactation was determined as the caliper units at weaning minus the caliper units pre-farrowing. Response variables included proportion of born alive and stillborn piglets, lactation feed intake, as well as removal and mortality risk for all causes, or specifically for reproductive and pelvic organ prolapse (POP) causes. Data were analyzed using generalized linear mixed models, hazard ratio analysis, and survival models with the lmer, glmer, and surv functions of R. Sow served as the experimental unit. Caliper measurements at farrowing had curvilinear associations (P < 0.05) with percentage born alive piglets and percentage stillborn piglets. Increasing caliper units at farrowing resulted in linear reduction (P < 0.05) in lactation average daily feed intake and in linear increase (P < 0.05) in caliper losses during lactation. Sows losing 1 to 2, 3 to 4, or 5 and greater caliper units in lactation had 1.5, 1.8, and 2.4 times, respectively, greater risk (P < 0.05) of being removed from the herd in the next cycle compared with sows that gained 0 or more units. Reduced caliper units in due-to-farrow sows resulted in reduced probability (P < 0.05) of survival in the next cycle considering prolapse removal reasons. Sows with due to farrow caliper units of 12 to 15 had 1 to 1.6 times (95% Odd Ratio Confidence Interval), 9 to 11 had 1.2 to 2.1 times, and less than 9 caliper units 3.1 to 3.2 times greater risk of death or being removed from the herd due to POP compared with those with >15 units. Reduced caliper units in due-to-farrow sows resulted in reduced probability of survival in the next cycle considering all removal and mortality causes. Specifically, sows with less than 9 caliper units at farrowing had 2.0 times greater risk (P < 0.05) of removal and 4.4 times greater risk (P < 0.05) of mortality compared with sows with over 15 caliper units. In summary, both under and over-conditioned sows have reduced productivity. Underconditioned sows are at greater risk for mortality and for POP related removal.