This study aimed at identifying possible pre-slaughter indicators and/or indexes to be used to predict pig stress response and meat quality variation. Data were collected on 44 shipments (loads) of Italian heavy pigs. For each shipment, several pre-slaughter parameters were recorded on farm, during transport, and at the slaughterhouse. Blood and meat samples were taken from 10 pigs from every of the 44 loads included in the study (N = 440). Blood samples were used to assess cortisol and creatine kinase levels, whereas meat samples were used to assess meat quality (pH, instrumental color, tenderness, water-holding capacity, and sensory analysis). Cluster analysis of blood parameters allowed the categorization of the shipments into two main clusters: Lower Stress (LS) and Higher Stress (HS). The variables/indexes statistically differing between the two clusters were: average vehicle speed during transport, welfare index at slaughter (i.e., “slaughter score”), overall transport and slaughter welfare index (TSWI), distance travelled, and behaviors (slips, falls, overlaps) during unloading, which appeared to be the best descriptors of the welfare conditions experienced by Italian heavy pigs during pre-slaughter handling. No consistent effects of the stress level experienced on meat quality was detected, which warrants the need for further studies conducted under more variable pre-slaughter conditions, with the aim of simplifying and improving the TSWI.