Trypanosoma vivax is a hemoparasite of major veterinary importance, causing trypanoso-miasis in domestic and wild ruminants. While cattle are widely recognized as susceptible hosts, water buffaloes are increasingly reported to develop acute, subacute, and chronic infections with severe health and production impacts. This review critically evaluates the current knowledge on T. vivax in buffaloes, focusing on pathogenesis, epidemiology, clin-ical manifestations, diagnostic approaches, therapeutic challenges, and control strategies. Data from Africa and South America are synthesized, with particular emphasis on out-breaks in the Amazon Biome, especially Marajó Island (Brazil), where buffalo farming represents a key economic activity. Advances in molecular diagnosis, such as PCR-based methods, are compared with traditional parasitological and serological tools, and their applicability in field conditions is discussed. Current chemotherapeutic options, emerging reports of drug resistance, and perspectives for vaccine development are examined. In ad-dition, integrated control strategies considering mechanical vectors, iatrogenic transmis-sion, and biosecurity practices are highlighted. This review identifies critical gaps in re-search and provides practical recommendations for surveillance and disease manage-ment in buffalo herds. The information presented here aims to support veterinarians, re-searchers, and policymakers in designing sustainable strategies to mitigate the impact of T. vivax in tropical livestock systems.