The aim of this study was to estimate the frequency of physiological and pathological reproductive conditions in female Italian Mediterranean Buffaloes. Female animals (n=444), ranging from 3 to 14 years of age were monitored by ultrasonography (USG). A total of 7319 USG images were collected and analyzed for pregnancy status, fetal sexing, gynecological measurements and pathologies. While pregnancy rate was determined as 38.75% and ovarium-genital canal disorders as 11.71%; the most common pathologies in nonpregnant animals are defined as ovarian cystic degeneration (OCD), hydrosalpinx and salpingitis (SALP), metritis, pyometra (METR) and pneumovagina (PVAG). OCD represented 4.27% of pathological conditions during long day season (February-June) with a higher frequency above 5 years of age (P