A two-year-old Large White boar from a pig breeding stock in an indoor farm in Switzerland presented anorexia, reduced general condition and fever. Despite antibiotic and anti-inflammatory treatment, the boar developed severe dyspnoea and cyanosis, and died after 4 days. At necropsy, no gross lesions were observed. Histopathologically, multifocal degeneration and necrosis of myocardial fibers with interstitial edema, severe multifocal non-suppurative myocarditis and hepatitis, and non-suppurative interstitial nephritis were observed. In heart samples, groups of organisms resembling apicomplexan tachyzoites were seen associated with the lesions. A PCR using the primers COC1-COC2 that target a conserved region of the small-subunit rRNA gene of Apicomplexa was performed with DNA from paraffin-embedded tissues. An amplification product of about 350bp was obtained from heart samples. A sequence analysis showed 100% identities with GenBank sequences reported for Sarcocystis miescheriana. The histopathological observations and molecular findings in combination with the clinical signs, and absence of other pathologic agents highly suggested that an acute infection with S. miescheriana was the cause of death in this boar. To our knowledge, this the first report of fatal acute sarcocystosis after natural infection in a pig breeding herd.