One of the most prevalent postoperative complications following rumenotomy is rumino-cutaneous fistulation, that can cause significant economic issue in ruminant. The aim of this study was to determine the clinical, hematobiochemical, and ultrasonographic variations in rumino-cutaneous fistulation before and after surgical correction in buffaloes. Five buffaloes with rumino-cutaneous fistulation and five clinically healthy buffaloes were evaluated in this study. Buffaloes with rumino-cutaneous fistulation exhibited reduced appetite, decreased rumen motility, scanty feces, and significant alterations in hematobiochemical parameters compared with clinically healthy control buffaloes. Ultrasonographically, buffaloes with rumino-cutaneous fistulation displayed a significantly lower rate of rumen contractions and a substantial increase in the thickness of ruminal and abdominal walls. Significant postoperative improvement in clinical, hematobiochemical, and ultrasonographic parameters in affected buffaloes was noted compared with clinically healthy buffaloes. In conclusion, rumino-cutaneous fistula is a common surgical complication of rumenotomy and rumen trocarization in buffaloes. Ultrasonography, clinical and hematobiochemical examinations are essential for the proper assessment of rumino-cutaneous fistulation before and after surgical correction in buffaloes.