This study aimed to evaluate the role of ultrasonography in outlining the different etiologies of left abdominal distension in non-pregnant cattle. Sixty non-pregnant cows with a history of left abdominal distension that not responded to treatment were used in this study. Thorough clinical examination and biochemical analysis failed to locate the cause of distension. Four different abdominal disorders including 32 cases of traumatic reticuloperitonitis (TRP), 10 cases with left abomasal displacement (LDA), 12 with frothy tympany and 6 with a diaphragmatic hernia (DH) were identifed. All cases underwent to left laparotomy for confirmation and treatment. B-mode ultrasound was a quick, feasible, and non-invasive diagnostic tool that revealed subtle variations for different etiologies. In LDA-affected cows, the abomasum was imaged at the left paralumbar region with its heterogeneous content and echogenic folds. TRP-affected cows showed thickened echogenic reticular wall with hypoechoic effusions and echogenic fibrinous deposits. While in DH-affected cows, the echogenic reticular wall was seen inside the thoracic cavity at the level of the 4thintercostal space (ICS). It could be concluded that ultrasonography is a relatively accurate ancillary tool for assessing and differentiating the identified etiologies of abdominal distension in cows.