Taenia solium cysticercosis is a zoonosis of public health importance in areas where the disease is endemic, with significant economic impacts on human health and the swine industry. Several gaps remain in the epidemiology of the parasite and the strategies of control in developing countries. We detail the key factors to consider in Madagascar in terms of the porcine husbandry system, Taenia transmission cycle, and diagnosis of cysticercosis in pigs, in order to better estimate the sanitary and economic impacts of this parasitic disease as well as to define an integrated control program.