Simple Summary This review summarizes the available information on the ex-vivo survival of the porcine reproductive and respiratory syndrome virus (PRRSV), the cause of porcine reproductive and respiratory syndrome in pigs. We highlight the possible role of different fomites and environmental sources in indirect transmission of this virus to susceptible hosts. The number of studies on this topic is limited but fomites (porous, non-porous, and liquid), insects, people, and pork meat have been studied, mostly under experimental conditions.Abstract Porcine reproductive and respiratory syndrome (PRRS) is one of the most economically important diseases of swine, with losses due to poor reproductive performance and high piglet and growing pig mortality. Transmission of porcine reproductive and respiratory syndrome virus (PRRSV) may occur by both direct and indirect routes; the latter includes exposure to PRRSV-contaminated fomites, aerosols, and arthropod vectors. This review has collected available data on the ex-vivo environmental stability and persistence of PRRSV in an effort to highlight important sources of the virus and to determine the role of environmental conditions on the stability of the virus, especially temperature. The ex-vivo settings include fomites (solid, porous, and liquid fomites), insects, people, and pork meat, as well as the role of environmental conditions on the stability of the virus, especially temperature.