Antibiotic treatment for endometritis has some weaknesses due to its toxicity and unexpected side effects. Therefore, the utilization of plant extract as antimicrobials is an alternative to antibiotics. We aimed to evaluate the efficacy of betel leaf, moringa leaf, and garlic extracts in treating endometritis in Aceh cows. We used nine Aceh cows at 3-5 years old, 150-250 kg body weight, and were diagnosed with endometritis through the White Side Test (WST). All cows were injected with 25 mg Prostaglandin (PGF2α) hormone and cervical mucus was collected 8-12 h post-estrus onset. A 20 mL of red betel leaf, moringa leaf, and garlic extracts with a concentration of 40% was administered every 24 h for 7 days. The extract application was carried out using an insemination gun inserted into the uterus. Post-treatment, the cows were re-synchronized with PGF2α and artificially inseminated after showing symptoms of estrus. Pregnancy was diagnosed using rectal palpation 60-90 days post-insemination. WST score data and total bacterial counts were analyzed using the Wilcoxon test, whereas the reproductive performance data were reported descriptively. The results showed that the administration of betel leaf, moringa leaf, and garlic extracts tended to reduce the WST scores and bacterial counts. The successful pregnancy rates in groups treated with betel leaf extract, moringa leaf, and garlic extract were 66.6, 66.6, and 0.0%, respectively. The application of red betel leaf extract and moringa leaf could reduce the level of endometritis and increase the pregnancy rates in Aceh cows.