This paper reviews the pros and cons of various alternatives to the surgical castration of male piglets without pain relief. Castration is mostly motivated by the presence of boar taint in the meat from some entire male pigs. It results in pain during surgery and markedly increases feed costs and the fat content of the carcass. Raising entire male pigs avoids pain at castration, but animals can suffer from increased stress during the finishing period because of aggressive and mounting behavior. Feed efficiency and carcass quality are much better than in surgical castrates. The quality of meat from entire male pigs is lower because of boar taint, a reduced intramuscular fat content, and increased unsaturation of the fat. Immunocastration prevents boar taint, pain associated with surgery, and stress related to aggressive and mounting behavior. Feed efficiency and carcass quality are intermediate between surgical castrates and entire males. Meat quality is similar to surgical castrates. Anesthesia alone prevents pain during surgery, but not after, while analgesia alone mitigates pain after surgery, but not during it. With the currently available methods, the cost of combined anesthesia and analgesia is too high for conventional production systems in most countries.