Piglets often undergo several painful treatments during the initial days of their lives. In this review, we investigate the acute (i.e., immediate), short-, and long-term implications of piglet processing on behavioral, physiological, clinical, and performance parameters, and how welfare impairments depend on performance instead of sham procedure, alternative techniques, or the age of the piglets. Welfare indicators that have been used to determine the least distressing procedures and knowledge gaps with regard to the procedures are identified and discussed. Tail docking and especially piglet castration have been the most researched topics, whereas marking for identification has been rarely addressed. Few or no studies have investigated the effects of teeth resection and tail docking on piglets of different age groups. Additionally, results are often found to be inconsistent, highlighting the need for additional research to determine the optimal age for processing. Studies comparing different processing techniques have produced contradictory results, but ear notching, teeth clipping, hot cautery tail docking, and tearing during castration have been determined to result in increased pain. Generally, a shorter procedure duration can reduce stress, with operator training having a distinct impact on piglet welfare during processing. As such, these topics should be further investigated.