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Accurate and timely pregnancy diagnosis in buffaloes is critical for effective reproductive management, improved fertility rates, and enhanced farm productivity. Various diagnostic methods have been developed and implemented, each with unique advantages and limitations in terms of accuracy, cost, ease of use, and stage of pregnancy detection. Traditional methods such as rectal palpation and observation of non-return to estrus remain widely used due to their simplicity and low cost. However, these techniques may lack precision or require skilled personnel. Advances in technology have introduced more reliable methods including ultrasonography, which allows early and accurate detection, and hormonal assays (e.g., progesterone, PAGs), which offer valuable biochemical insights into pregnancy status. Emerging techniques such as molecular diagnostics, immunoassays, and biosensors are also being explored for their potential to provide rapid, non-invasive, and on-field diagnosis. This review article highlights the principles, applications, benefits, and constraints of various pregnancy diagnosis methods in buffaloes, aiming to guide veterinarians and farmers in selecting the most appropriate approach based on their specific needs and resources.