Endemic diseases constitute a major threat for a profitable and sustainable pig production worldwide. This chapter reviews the diagnosis and monitoring of pig diseases, and control measures that can be implemented on the farm. The most important issues to establish a diagnosis are discussed. Monitoring of pig diseases should focus on different parameters such as clinical signs and antibiotic usage, animal responses to infection and detection of pathogens, lesions in slaughter pigs, and feed and drinking water intake. Advantages and disadvantages of different levels of disease control are discussed. The importance of management and biosecurity is illustrated, with an overview of the components of external and internal biosecurity. The role of vaccination and antimicrobial medication is discussed, followed by future trends for improving diagnosis and disease control. Future research is warranted to better understand host–pathogen interactions and to develop better diagnostics, vaccines and control measures against infectious pig diseases.