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Lamb mortality is a key factor influencing ewe productivity and profitability. The current study investigated risk factors associated with and management practices implemented on sheep farms to reduce lamb mortality. A survey consisting of 13 multiple-part questions (57 separate questions) was administered to all sheep farmers participating in the Teagasc National Farm Survey, representative of the Irish national population of sheep farms. A total of 60% of respondents identify mating or lambing date, and this practice tended to be associated with reduced lamb mortality (1.2%, p = 0.08). Individual lambing pens were used by 88% of farmers, but 26% did not clean or disinfect them. A total of 79% and 9.5% of farmers applied iodine to all lambs’ navels and administered antibiotics to all lambs to treat and/or prevent diseases, respectively. Most farmers vaccinated their ewes (86%) and lambs (79%) against clostridial diseases and/or pasteurellosis; 13% vaccinated against abortion agents. Lamb mortality tended to be lower (Kruskal–Wallis (KW) = 2.749; p = 0.09) on farms that used stomach tubing, heat box, iodine, hospital, and individual pens compared with farms that do not implement all those practices. Predators, lamb birth weight, and diseases were perceived by respondents to be the three main causes of live-born lamb mortality. The gross margin is significantly higher on lowland farms by €37 per ewe compared with hill farms (Kruskal–Wallis (KW) = 4.056; p < 0.001). The combination of full-time farming and the use of hospital and individual pens improved gross margin (€18/ewe, p = 0.028). It is concluded that on-farm management practices affect both lamb mortality and flock gross margin.