Reductions in voluntary feed intake during disease, or disease hypophagia, is a common phenotype observed in nearly all species. However, the extent to which disease hypophagia explains attenuated pig performance during disease is poorly defined. The objective of this study was to describe the extent to which hypophagia explains pig performance during a Porcine Reproductive and Respiratory Syndrome (PRRS) virus challenge. Twenty-four PRRS naïve barrows (12.8 ± 0.73 kg BW; Landrace x Large White, PIC) were selected, blocked by body weight, and allotted across three treatments (n=8/trt): 1) PRRS-naïve, ad libitum fed (Ad), 2) PRRS-inoculated, ad libitum fed (PRRS), and 3) PRRS-naïve, pair-fed daily to the PRRS pigs (PF) to mimic disease feed intake. All pigs were individually penned and after a 4-day acclimation, on days post inoculation (dpi) 0, PRRS pigs were inoculated with PRRS virus. Over 7 dpi, daily feed intake and body temperatures (BT), and 7 day ADG, ADFI, and G:F were assessed. Over the 7-day challenge period, a treatment x time interaction (P < 0.0001) was reported for ADFI in which PRRS and PF pigs’ ADFI was reduced by 51% compared with Ad pigs. Compared with Ad pigs, PRRS and PF pigs end BW was reduced by 23% (P = 0.004). The Ad pigs had greater ADG compared with PF and PRRS pigs (0.64, 0.12, -0.04 g/d, respectively, P < 0.0001). Overall G:F was reduced by 112% and 53% in the PRRS and PF pigs, respectively, compared with Ad pigs (P < 0.0001). A treatment x dpi effect was reported in core BT, in which PF pigs; BTs reduced over time compared with Ad and PRRS pigs (38.7, 39.4, 39.6 °C, respectively, P = 0.001). In summary, disease hypophagia explains much of the reduced growth observed during PRRS challenge.