Worldwide production of buffalo milk is steadily increasing. In this chapter, the worldwide distribution of buffalo milk production is described, with emphasis on production styles and characteristics by region. Representative buffalo breeds are described, along with production levels and general herd management. Relevant factors such as heat stress, animal nutrition, conversion efficiency, health management, calf rearing systems and sanitary milk production conditions are outlined. Factors influencing buffalo milk performance and production are also outlined in this chapter such as sexual maturity, calving interval, days in lactation, residual milk and performance according to age groups.