This study aimed to compare the clinical and metabolic results obtained by use of one-step laparoscopic abomasopexy and right paralumbar fossa abomasopexy for the treatment of left displaced abomasum in dairy cows. Thirty Holstein-Friesian dairy cows were randomly placed in two groups: G1, with 15 animals treated by one-step laparoscopic abomasopexy; and G2, with 15 animals treated by right paralumbar fossa ventral abomasopexy. Concentrations of sodium, potassium, chloride, bicarbonate, base excess (BE), pH, partial pressure of carbon dioxide (pCO2) strong ion difference (SID), anion gap (AG), glucose, β-hydroxybutyrate (BHBA) and non-esterified fatty acids (NEFA) were measured before (M0) and 24 (M1), 48 (M2) and 72 (M3) hours following surgery. Laparotomy was statistically faster than laparoscopy. Hypochloremia was observed only in G2 at M0. Hypokalemia and hypocalcemia were observed in both groups at M0, increasing after surgery. Metabolic alkalosis in both groups before surgery was characterized by high bicarbonate, pCO2, and BE, which decreased in subsequent time points, as well as blood pH. Glucose was statistically increased and NEFA and BHBA were statistically decreased in G2 compared to G1. In G1, NEFA and BHBA decreased significantly following surgery. Both surgical techniques restored abomasal flow and feed intake in both groups. Based in acid-base status, one-step laparoscopy showed no additional advantage in comparison with abomasopexy via right paralumbar fossa.