The increasing demand for higher inclusion cleanliness levels motivates the control over the formation and evolution of inclusions in the steel production process. In this work, the evolution of the chemical composition and size distribution of inclusions throughout a slab production process of Al-killed steel, including ladle furnace (LF) treatment and continuous casting (CC), was followed. The initial solid Al2O3 and Al2O3-MgO inclusions were modified to liquid Al2O3-CaO-MgO inclusions during LF treatment. The evolution of the size distributions during LF treatment was associated with the growth and removal of inclusions, as new inclusions were not created after the deoxidation process, according to a population density function (PDF) analysis. Additionally, the size distributions tended to be similar as the LF treatment progressed regardless of their initial features, whereas they differed during CC. Analysis of the upper tails of the distributions through generalized extreme values theory showed that inclusion distributions shifted from larger to smaller sizes as the process progressed. There were great changes in the distributions of large inclusions throughout the LF treatment and between the end of the LF treatment and the start of the CC process. Additionally, distributions of large inclusions differed at the end of the LF treatment, whereas such differences decreased as CC progressed.