This paper was aimed to characterize clinical signs and pathomorphological lesions in twenty-two pigs, infected intranasally by different doses of African swine fever virus (Pol18_28298_O111), isolated during the outbreak in a pig farm that occurred in Eastern Poland throughout 2018. This article also attempts to indicate risk, related to virus load and shedding, and present possible difficulties with proper disease recognition at the farm level. The results revealed that even a very low dose (5 HAU) may initiate the infection. Various forms of the disease (acute, subacute, and chronic), mainly with prodromal clinical signs like fever, apathy, and reduced feed intake were observed. The most frequently observed lesions (82%) were: hyperemia and enlargement of lymph nodes and splenomegaly. The minimal incubation period was estimated at five days post-infection (dpi). Mortality ranged from 80–100%. Two pigs survived the infection. Some viremic animals presented delayed fever. In some cases, the fever was not detectable. Shortly after viremia, the virus was secreted ion the urine, feces, and saliva. The highest levels of virus were found in the internal organs and blood; however in the case of one pig (chronic form), viral DNA was not detected in the spleen, liver, bone marrow, and brain. Veterinary diagnosis may be difficult, and the final results should always be based on laboratory investigations.