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A twelve years old pluriparous cow was subjected to a complete vaginal prolapse since 48 h with lacerated, dry and edematous cervico-vaginal mucosa. Several trials to reduce the prolapsed part using ordinary manual replacement were imposed but failed due to the large size of the prolapsed part and the increased abdominal pressure due to full term pregnancy occupying the abdominal cavity leaving no space to the prolapsed part. Caesarian section was suggested as a last resort to treat the prolapse. Left upper flank approach for the caesarian section was performed in the standing position. After extracting the dead fetus, the prolapsed part was replaced and settled. The vulval lips were sutured using sterile gauze tape and Gerlach needle. The operated cow was followed and its future fertility was assured 3 months later with no further complications. It can be suggested that caesarian section can be the last resort to treat old non reducible vaginal prolapse in full term pregnant buffalo cow.