Mycotoxins are the most widely existing pollutants in both dietary provisions and livestock feed, and they pose a series of hazards for humans and animals. Deoxynivalenol (DON) is a prevalent mycotoxin that is primarily produced by Fusarium spp. and commonly found in various cereal products. Feeding swine diets contaminated with trichothecene DON can lead to major adverse effects, including reduced feed intake, diminished weight gains, and compromised immune function. Among all animal species, swine are the most sensitive to DON. Here we explore the disruption of gut health by DON, considering aspects such as intestinal histomorphology, epithelial barrier functions, immune system, microflora, and short-chain fatty acid production in the intestines. Numerous additives have been documented for their potential in the detoxification of DON. These additives can alleviate the toxic effects of DON on pigs by modulating the Nrf2-Keap1, mitogen-activated protein kinases (MAPKs) and Nuclear factor kappa-B (NF-κB) signaling pathways. Additionally, there are additives capable of mitigating the toxicity of DON through adsorption or biotransformation. This update has novel potential for advancing our comprehension of the mechanisms linked to DON intestinal toxicity and facilitating the formulation of innovative strategies to mitigate the impact of DON.