This paper reviews information on antimicrobial resistance patterns and prudent use of antimicrobials to reduce the impact and spread of resistant Streptococcus suis strains. S. suis is an important pathogen in swine, which can cause significant economic loss. Prudent use of antimicrobials for S. suis is essential to preserve the therapeutic efficacy of broad-spectrum antimicrobials and to minimize selection of resistant S. suis strains. Resistance of S. suis to antimicrobials commonly used in swine, including lincosamides, macrolides, sulphonamides, and tetracycline, has been documented worldwide, with resistance in up to 85% of strains. Among antimicrobials examined, resistance of S. suis has been demonstrated to be relatively low for penicillin (0–27%), ampicillin (0.6–23%), and ceftiofur (0–23%). For penicillin, this result may be due in part to the unique mechanism by which resistance is acquired through modifications in the structure of penicillin-binding proteins. Recommendations to control S. suis infection include focused and careful choice and appropriate use of antimicrobials, together with preventive measures intended to improve swine management.