This study aimed to determine the effects of piglet birthweight (BIW) and sex, and within-litter BIW variation, on postnatal growth traits and meat quality in fatty breeds of pig. In total, 406 crossbred piglets (half male, half female) born to Iberian sows were studied during their postnatal development until slaughter. After birth, piglets were classified into four BIW categories: very low, low, medium and high. There was a negative effect of low BIW on growth patterns and fatty acid (FA) composition, but effects of litter size and within-litter BIW variation were not found. The very low BIW piglets underwent a period of significant catch-up growth (P < 0.005) relative to high BIW piglets during the early postnatal phase, but also showed a higher feed conversion rate and lower average daily weight gain (P < 0.05 for both measures) throughout the study period. BIW affected development during the entire productive life, and the sex effect increased with age. As a result, the period to reach market weight was longer in very low BIW piglets, by 43 days for females and 15 days for males, compared with their high BIW counterparts. BIW and sex also influenced amount of intramuscular fat, n-3 FA content and monounsaturated FA composition. The study indicates that BIW, modulated by sex, is a critical point for productive traits in fatty pigs. These results provide a basis for future strategies to enhance productive efficiency and meat quality of traditional swine breeds.