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This article presents the results of a study assessing the physical and mental health of residents living in the vicinity of a large-scale swine confinement operation. Physical and mental health data were collected via personal interviews from a sample (n = 18) of all neighbors living within a two-mile radius of a 4,000-sow swine production facility. Results were compared to similar data collected from a random sample of demographically comparable rural residents (n = 18) living near minimal livestock production. Results indicate that neighbors of the large-scale swine operation reported experiencing significantly higher rates of four clusters of symptoms known to represent toxic or inflammatory effects on the respiratory tract. These clusters of symptoms have been well-documented among swine confinement workers. There was no evidence to suggest that neighbors of the large-scale swine operation suffered higher rates of psychological health problems manifested as anxiety or depression. A larger population-based study is needed to test the hypothesis that neighbors of large-scale swine operations experience elevated rates of physical health symptoms comparable to interior confinement workers.