This study was conducted to determine the prevalence, distribution pattern, and the Sarcocystis species involved in slaughtered water buffaloes (Bubalus bubalis) in the Khuzestan, Iran by macroscopic and histological examination. The esophagus, heart, diaphragm, tongue, masseter, and thigh muscles were investigated. Esophagus and thigh muscles of only 3 of the 100 examined water buffaloes (3%) were infected with macroscopic Sarcocystis, whereas at microscopic level Sarcocystis were found in 83 of the 100 examined animals (83%). The highest prevalence rate of microscopic cysts was found in masseter muscle (57.1%) and then followed by tongue, diaphragm, esophagus, heart, and finally, thigh muscles (30.0%). There was no significant difference between males (83.6%) and females (82.0%) or between two investigated age groups (a parts per thousand currency sign2 years old, 78% versus > 2 years old, 88%). Based on the size of the sarcocysts, thickness of the walls and location of the cysts, Sarcocystis buffalonis as a macroscopic form and Sarcocystis levinei and Sarcocystis dubeyi as the microscopic forms were diagnosed in the examined muscles of the buffaloes of this area. Sarcocystis fusiformis was not seen in the examined organs of these buffaloes. The high prevalence rate of microscopic Sarcocystis in this region indicates that dogs have a more significant role than cats in transmission of these protozoa.