In 1987, porcine reproductive and respiratory syndrome (PRRS) was recognized in the USA as a new disease of swine causing late-term reproductive failure and severe pneumonia in neonatal pigs. The syndrome is caused by an RNA virus referred to as PRRS virus (PRRSV), which is classified in the family Arteriviridae. Swine macrophages are the only indigenous cell type known to support PRRSV replication. Direct contact between infected and naive pigs is the predominant route of PRRSV transmission. Exposure of a mucosal surface to PRRSV leads to virus replication in regional macrophages, a prolonged viremia and systemic distribution of virus to other macrophage populations. Reproductive failure induced by PRRSV infection in late-gestation sows is characterized by premature farrowing of stillborn, partially autolyzed, and mummified fetuses. Pneumonia caused by PRRSV infection is more severe in young pigs compared to adults and may be complicated by concurrent bacterial infections. Gross lung lesions associated with PRRSV infection vary from none to diffuse consolidation. In addition, multiple lymph nodes may be markedly enlarged. Microscopically, PRRSV-pneumonia is characterized by multifocal, interstitial thickening by macrophages and necrotic cell debris in alveoli. Other less common microscopic lesions of PRRSV infection include myocarditis, vasculitis, encephalitis, and lymphoid hypertrophy and hyperplasia. In acute or subacute PRRSV infections, serum and lung are the best specimens for diagnosis. Persistent PRRSV infections can be produced by transplacental or intranasal infection. Persistent PRRSV infections are an important factor for virus survival and transmission within a swine herd and will complicate control programs.