This paper reviews methods to mitigate heat stress among high productive sows. The investigated methods comprise increased ventilation, increased air velocity, snout cooling, air cooling, floor cooling, radiative cooling, drip cooling, sprinkling of water onto the sows and increased insulation. The review shows that it is very different how well the expected effect of the different methods is documented in the scientific literature. For floor cooling, snout cooling and drip cooling scientific evidence shows that these methods are effective at reducing respiration rate, increasing feed intake, increasing weight gain among piglets during lactation and reducing rectal temperature. In contrast, no studies are found that demonstrates how effective increased velocity is at mitigating heat stress among sows. A relatively good existing knowledge on how air temperature affects different parameters that is associated with heat stress is useful in the assessment of methods that targets the room temperature. Among these methods, the potentials of increased ventilation are expectably well utilized in modern pig housing. The potentials associated with air cooling are generally large, however for air conditioning it involves large energy costs, and for evaporative cooling it requires relatively low air humidity.