This review aims to describe changes in production environment, management tools and technology to alleviate problems seen with the present hyperprolific sow model. Successful parturition in the pig includes the possibility to express adequate maternal behaviour, rapid expulsion of piglets, complete expulsion of placenta, elimination of uterine contamination and debris, neonatal activity and colostrum intake. We focus on management of large litters, including maternal behaviour, ease of parturition, colostrum production, piglet quality parameters and intermittent suckling. There are also some interesting developments in technology to assess colostrum and immune state of the piglet. These developments may be utilized to improve the success rate of reproductive management around farrowing, lactation and after weaning. We also discuss new insights in how to examine the health of the mammary gland, uterus and ovaries of hyperprolific sows. Finally, we assess the latest developments on breeding and technology of hyperprolific sows, including artificial insemination (AI), real-time ultrasound of the genital tract and embryo transfer (ET). We conclude that 1) for the sow to produce sufficient colostrum, both the behavioural and physiological needs of the sow need to be met before and after parturition. Furthermore, 2) new ultrasound and biopsy technology can be effectively applied for accurate diagnosis of inflammatory processes of the udder and uterus and timing of AI regarding ovulation to improve insemination efficiency. Finally, 3) developments in cryopreservation of germ cells and embryos appear promising but lack of valid oocyte collection techniques and nonsurgical ET techniques are a bottleneck to commercial ET. These latest developments in management of parturition and reproductive technology are necessary to cope with the increasing challenges associated with very large litter sizes.