This study aimed to characterize and quantify reasons for the removal of nurse sows and identify the removal associated with their extended lactation length (ELL). A total of 100,756 removed nurse sows within a period of 2016–2022 from 53 sow herds in the Midwest USA were analyzed. Reproductive failure was the most common removal reason (χ2 = 8748.421, p < 0.001) affecting P1, P2, and P3 nurse sows. Failure to conceive and absence of estrus were the main causes of reproductive failure (χ2 = 352.480, p < 0.001) affecting P1 and P2 nurse sows and P1 and P5 nurse sows, respectively. When P2 and P6 nurse sows had an ELL of 0–7 d, they faced a high chance (χ2 = 13.312, p = 0.021) of removal due to conception failure and failure to return to heat, respectively. When P2 and P5 nurse sows had an ELL of 8–14 d, they were highly vulnerable (χ2 = 59.847, p < 0.001) to removal due to failure to conceive and showing heat, respectively. Finally, when ELL was at 15–21 days, P4 and P5 nurse sows were more likely (χ2 = 41.751, p < 0.001) to be removed due to failure to express heat, whereas at the same time, P2 and P3 nurse sows experienced the same removal threat due to failing to conceive. These results could help producers manage nurse sow systems.