This study examined the relationship between lung lesion severity and presence of antibodies of various respiratory pathogens, and the effects of lung lesion severity on growth performance, biochemical indicators, total aerobe counts, and carcass and meat quality indicators in total of 240 slaughter pigs originating from two farms with similar rearing conditions. Lung lesion severity was calculated based on the degree of pneumonia and pleurisy in slaughtered pigs. Two-step cluster analysis was used to place individual pigs to four clusters according to pneumonia and pleurisy scores: no lung lesions (cluster 1); mild lung lesions (cluster 2); moderate lung lesions (cluster 3); and severe lung lesions (cluster 4). ANOVA and post hoc pairwise comparisons using Tukey’s test were performed to assess the differences between clusters in examined variables. Multivariate linear regression analysis was run to identify associations between lung lesions and examined variables. There was a strong evidence of association between the absence of lung lesions and increased albumin, sodium and chloride levels, daily weight gain, live weight, hot carcass weight, cold carcass weight, loin thickness and carcass lean content, and decreased haptoglobin, CK and LDH levels. Also, pigs without lung lesions produced the highest percentage of red, firm and nonexudative pork. Pigs having severe lung lesions had the highest percentage of simultaneously seropositive samples to SIV, PRRSV, PCV-2, PRCV, APP and M. hyopneumoniae. There was a strong evidence of association between the presence of severe lung lesions and decreased lactate, glucose, sodium, chloride and albumine levels, daily weight gain, live weight, hot carcass weight, cold carcass weight, loin thickness and carcass lean content, and increased CK, LDH and haptoglobin levels. There was a strong evidence of association between the presence of severe lung lesions in slaughered pigs and increased meat pH and sensory colour scores, and decreased drip, thawing and cooking losses and L* and b* values, which led to the highest occurrence of moderate DFD and DFD pork. There was a strong evidence of association between the presence of mild lung lesions in slaughtered pigs and decreased meat pH and sensory colour scores, and increased drip, thawing and cooking losses, L* and b* values, which led to the highest occurrence of moderate PSE and PSE pork. In conclusion, the presence of lung lesions, irrespective of severity, was significantly associated with alterations in the biochemical indicators, growth performance and carcass and meat quality in slaughtered pigs.