Artificial insemination (AI) is now used for breeding more than 90 % of the sows in most of the world’s primary pork producing countries. Despite the advancement of methods to cryopreserve boar semen, frozen semen has not been routinely used on farms because of limited efficiency. Liquid semen on the other hand with 1.5 to 3 billion sperm per dose preserved up to seven days in long-term extenders is in common use and is largely responsible for the widespread use of AI. Breeding organizations have defined individual thresholds for useable semen at 60 to 80 % for motility and bacterial load of 0 to 1000 CFU/mL. Improvement in preservation techniques for liquid semen and improved pig producer education has been responsible for the higher efficiency of pig breeding as measured by conception rate and increased litter size with a minimum number of sperm. The introduction of deep intrauterine AI and advances in breeding management have also been contributing factors. The present article reviews the worldwide application of preserved boar semen from past to present and delineates future challenges. Pathways to increase breeding efficiency are outlined. The reconciliation of AI with sustainable breeding strategies is increasingly important. In this sense, guidelines for the prudent use of antibiotics in semen extenders are proposed. More efficient and sustainable pig AI awaits the introduction of sex-sorted sperm into AI practice. Another critical milestone that needs to be achieved is the replacement of conventional antibiotics in extenders.