The current trend of pig/swine production towards intensive industrialised production creates a window of opportunity for pathogens to spread between and within farms. The main focus of vaccination are gilts and weaners. For gilts the challenge is to acclimatise them before entering the breeding stock while, for piglets, the challenge is to immunise them in the presence of maternally derived antibodies (MDA). Vaccination remains a powerful tool to prevent infectious diseases but faces difficulties in dealing with endemic disease. The development of newer vaccines and adjuvants, as well as a better knowledge of pig immunology and of the epidemiology of diseases, may help to improve our approaches to vaccination. This chapter reviews the current use of vaccines and vaccination programs in controlling endemic diseases in pigs. It also discusses the future of vaccines and vaccination in pigs.