Preweaning mortality in piglets is a welfare issue, as well as an ethical and economic concern in commercial pig farming. Studying the causes of preweaning mortality and their prevalence is necessary to reduce losses. Preweaning piglet mortality was investigated in a field study including 347 sows from 14 loose-housed Norwegian piglet-producing herds. A total of 5254 piglets were born in these herds during the study period, and 1200 piglets were necropsied. The cause of death was based on pathoanatomical diagnosis (PAD). Preweaning mortality of all piglets in the study was 23.4%, including 6.3% stillborn. The two main causes of preweaning mortality in live-born piglets (n=4924) were trauma (7.1%) and starvation (2.7%). Piglets dying of an infection accounted for 2.0%. Among the necropsied piglets (n=1200), 29.1% had died due to trauma, 26.8% were categorized as stillborn and 11% had died of starvation. Piglets that had died of trauma, had a mean time of death of 1 lactation day (LD 1), ranging from LD 0 to LD 21. The mean time of death of piglets that died due to bacterial infection was LD 9, ranging from LD 0 to LD 31, with Escherichia coli accounting for most infections found in necropsied piglets. Farmers were able to identify death by trauma in piglets, but were less able to identify death due to hunger. Most piglets that died in the preweaning period, died of trauma. Surprisingly, this included large and well-fed piglets. The second most prevalent cause of preweaning mortality was starvation. Improved monitoring may reveal piglets with low body mass index, and additional nutrition may contribute to increase the survival rate.