Seventy-nine purebred and crossbred water buffaloes consisting of 43 animals without fasciolosis and 36 animals positive for fasciolosis through fecalysis were utilized to determine the ultrasonographic features of the liver with patent fasciolosis. Sedimentation technique of fecal samples revealed mixed parasitic infection of Fasciola spp. with strongyles, Moniezia sp., and Eimeria spp. However, besides Fasciola spp., the other parasites are not known to cause liver damage. Ultrasonographic features observed in the water buffaloes with patent Fasciola spp. infection were significantly more echogenic liver parenchyma due to presence of multiple hyperechogenic foci, thicker hyperechoic gall bladder wall, wider gall bladder lumen and less echoic gall bladder lumen. However, other abnormal liver and gall bladder conditions should be ruled out. The thickness of the liver parenchyma was not different between the two groups. The results of the study suggest that ultrasonography can be used as a complementary tool for diagnosis of patent fasciolosis in water buffaloes.