This paper presents some key results and conclusions from a review (Rutherford et al. 2011) undertaken regarding the ethical and welfare implications of breeding for large litter size in the domestic pig and about different ways of dealing with these implications. Focus is primarily on the direct adverse consequences for animal welfare of Danish breeding for large litter sizes due to increased piglet mortality and the subsequent attempts to reverse these consequences by breeding for number of live piglets at day five rather than number of piglets born. By this change of breeding goal it seems possible to achieve a drop in relative piglet mortality and the related welfare problems. However, there will be a growing problem with the need to use foster or nurse sows which may have negative effects on both sows and piglets. This gives rise to new challenges for management.