The present study was undertaken to elucidate the alkaline indigestion syndrome in riverine buffaloes caused by inadvertent colostrum feeding, clinical pattern and its therapeutic management. Fifteen recently parturited buffaloes with history of feeding average 2.96 kg (1 to 5 kg) of colostrum immediately after parturition followed by sudden onset of anorexia, decrease in milk yield and nervous signs were investigated. Clinical examination showed normal body temperature (100.26±0.42 vs 100.62±0.18), respiration (23.73±3.53 vs 24.13±0.66) and heart rate (57.26±3.30 vs 53.20±1.79) compared to healthy buffaloes. Examination of rumen revealed impaction with highly significant (P<0.01) reduction in rumen motility (0.80±0.24 vs 3.80±0.17 per five minutes). Similarly, highly significant (P<0.01) increase in rumen pH (8.10±0.16 vs 6.25±0.07) and decrease in protozoal density (5.00±0.88 vs 32.93±1.72) with sluggish (+) to no (-) protozoal motility was observed in ailing buffaloes. Haematological analysis showed normal blood profile with significant (P<0.05) increase only in neutrophil count (51.60±5.1 vs 42.06±3.4). Prominent clinical signs of anorexia, congested conjunctival mucosae, decreased milk yield and varied nervous signs like restlessness, head pressing, staggering gait, incoordination, circling, convulsions, dummy syndrome, apparent blindness and coma were observed in affected buffaloes. Postural abnormalities like sternal / lateral recumbency and lateral deviation of neck were also observed in two buffaloes. All the ailing buffaloes were treated with Dextrose Normal Saline, single dose of preparation containing calcium, phosphorus and magnesium, vitamin B complex, antihistaminic, sedatives, laxatives, pre, probiotics, and oral antibiotics. All the treated buffaloes showed satisfactory improvement from 1st to 3rd day with complete clinical recovery by 4.93 (3 to 9) days of treatment. Buffalo owners should be made aware of unscientific practice of colostrum feeding in adult animals and accidentally intoxicated buffaloes could be successfully treated with the standardized treatment protocol.