This review aimed to systematically map and summarize the status of animal health and welfare in organic production. The prevalence of diseases and behavioural effects in organic dairy cow, beef cattle, sheep, pig, laying hen and broiler chicken were discussed in the context of the organic values and current knowledge on animal health and welfare. In total 166 peer-reviewed scientific publications between 2008 and 2020 were included. No strong evidence for neither inferior nor distinctly higher animal welfare in organic compared with conventional production could be supported. The welfare status of organic livestock is in general good in relation to the OIE definition of animal health and welfare. However, organic systems are still facing several challenges related to animal health and the arising of goal conflicts due to management and practical implications. Greater possibilities to perform species-specific behaviours in organic production systems, however, indicate that the organic standards offer a good framework for high animal welfare management. For organic dairy farmers, the main health problems are similar to those of non-organic farms; especially mastitis and lameness need improvement. Parasites, together with mastitis and lamb mortality, are important welfare issues in organic sheep production. Piglet mortality, leg problems, parasite load and increasing respiratory problems are of major relevance in organic pig production. For organic laying hens, major health challenges relate to feather pecking and cannibalism, parasites and possibilities to express species-specific behaviours. For organic broilers, dermatitis of footpads, hocks and breast are reported as main health issues.