Supplementing suckling piglets with Lactobacillus reuteri isolated from a homologous source improves L. reuteri colonization number in the gastrointestinal tract, which can have health benefits. This study investigated dietary L. reuteri supplementation on the growth and health-including immune status-of piglets, as well as its colonization. A total of 60 sows with similar parity and body weight were allocated into one of three groups after secretion (n = 20 each, with 10 neonatal piglets of each): untreated control, L. reuteri supplementation, and antibiotic treatment. The experimental duration was 28 days, from birth of piglets to their group transferred. For the first 7 days after birth, all neonatal piglets were fed by sows. Piglets in the L. reuteri supplementation group were administered with 1.0 ml L. reuteri fermentation broth containing 5.0 × 10 CFU. From 7 to 28 days, piglets were given basal feed (control), basal feed supplemented with L. reuteri (1.0 × 10 CFU/g), or aureomycin (150 mg/kg). L. reuteri colonization in the distal jejunum and ileum was increased in piglets in the L. reuteri-supplemented as compared to the control group after 28 days, as determined by fluorescence in situ hybridization and real-time PCR analysis. Total Lactobacillus and Bifidobacterium counts in the cecum were higher whereas total aerobic bacteria (Escherichia coli and Staphylococcus) counts were lower in the L. reuteri as compared to the control group. L. reuteri supplementation also improved body antioxidant status and immune function relative to control animals. Strain-specific L. reuteri administered to piglets colonizes the intestinal mucosa and improves cecal microbiota profile and whole-body antioxidant and immune status, leading to better growth and lower morbidity and mortality rates.