The US swine industry is currently challenged by the potential of transboundary animal disease (eg, African swine fever) entry to the national herd and the relentless pressures of domestic diseases (eg, porcine reproductive and respiratory syndrome). The task of the swine veterinarian is to biosecure both the national herd and their customers' local farms to mitigate these risks. This Viewpoint raises 4 questions that swine veterinarians, including practicing (private and corporate), industry, research, academic, and regulatory (state and federal) veterinarians who spend a portion of their time controlling, treating, preventing, or eradicating diseases of swine, must answer to meet the needs of their farms to compete globally and survive. In addition, it appears that there is sufficient science-based information to move forward in a collaborative manner and that the goals of prevention of African swine fever and elimination of porcine reproductive and respiratory syndrome virus are technically possible. Therefore, as previous generations of swine veterinarians led the US industry in the elimination of foot-and-mouth disease virus, classical swine fever virus, and pseudorabies virus from the national herd, the central challenge is whether the next generation of veterinarians will provide the necessary leadership to deal with the current industry and its next-generation challenges.