Increased litter sizes in modern pig breeds have led to a significant number of pigs being born undersised and/or exposed to different degrees of intrauterine growth restriction (IUGR). The aim of this study was to examine the effect of piglet head shape as an identification method on performance indices. Data included all piglets from 203 litters, in total 3402 crossbred piglets. Piglets were classified at birth based on their head morphology (normal, mild IUGR and IUGR) and weighed at birth, Day 14 and at weaning (mean ± s.d.: 25.5 ± 1.23 days). The relative weight of the brain (to bodyweight) was greater in the mild IUGR (4.2%) and in the IUGR piglets (5.5%) compared with the normal piglets (2.8%) (P < 0.001). Weaning weight of the mild IUGR and IUGR piglets was reduced by 1.3 kg and 1.8 kg, respectively, compared with the normal piglets (P < 0.001). The average daily gain of the normal piglets (228 g/day) was higher than the mild IUGR (195 g/day) and IUGR piglets (181 g/day) (P < 0.001). The fractional growth rate (weight gained per day per starting weight) was, however, highest in the IUGR piglets followed by the mild IUGR and the normal piglets (P < 0.001) indicating the potential for catch up growth. Mild IUGR that were liveborn had twice as high a risk of dying before weaning than normal piglets whereas liveborn IUGR piglets had a 4.7 times greater risk of dying pre-weaning. The present study showed that piglets born with a 'dolphin-like' head shape have an impaired growth and increased risk of dying in the suckling period.