Post-weaning multisystemic wasting syndrome (PMWS) and other porcine circovirus type 2 (PCV2)-related diseases have been reported throughout the world for about 10 years. The present paper reviews the knowledge acquired in different fields and is largely based on the authors' experience. The horizontal transmission of PCV2 is widely documented. Contact between pigs is the main route of transmission for both PCV2 and PMWS. However, experimental inoculation of PCV2 to pigs does not give consistent results and severe clinical signs as encountered in the field are rarely obtained. It is thus acknowledged that additional conditions are required for the disease to be severe in growing pigs. These are not all known but co-infections are thought to act as triggers. The spread of such triggers/enhancers, which may or may not be infectious, could have played a role in PMWS dissemination via normal national and international trade, in some cases conferring an epidemic pattern to this spread. Most of the risk factors identified in surveys relate to poor biosecurity and inadequate hygiene/husbandry/herd management. The good correlation between viral burden in the tissues and disease severity emphasized the role of infection pressure. Genomic analysis showed great similarities between PCV2 isolates. However, although two main genotypes (genogroups) could be distinguished from the phylogenic trees, and changes with time, no clear relationship with strain virulence was apparent. Isolates detected in PMWS-positive pigs could also be detected in healthy pigs from healthy farms. A strong sow effect was observed in disease expression in the offspring. Colostrum composition and colostrum intake are supposed to be key components of disease expression. Medication is relatively inefficient as a control measure. Commercial PCV2 vaccines are now becoming available. However, losses as a result of PMWS and PCV2-related diseases are greatly reduced by applying appropriate hygiene and husbandry practices.