This study examines the uses of domestic water buffalo milk in south Sumatra, Indonesia, one of the few areas in not only Indonesia but also the Philippines where the rare practice of milking animals occurs in Southeast Asia. In south Sumatra, both milking domestic water buffalo (Bubalus bubalis) locally known as kerbao pampangan—and making milk products are frequently practiced. The research was thus conducted into the breeding and milking of domestic water buffalo and making of milk products in a Muslim village of the OKI District (Ogan Komering Ilir Regency), south Sumatra, using participant observation, interviews, and questionnaires, to understand the life and culture of the villagers. The findings revealed domestic water buffalo to be the main livestock used for the production and sale of either meat or milk products. Heated milk products, such as candy (gulo puan, sagon puan) and jelly (jerry susu) are produced, probably because fresh milk risks lactose intolerance or milk contaminants, but not yogurt (dadihi), which is produced in north Sumatra. Investigating such unique uses of milk in south Sumatra from an ecological anthropological viewpoint attests to an evident culture of milking domestic water buffalo in south Sumatra, and that arises from the relationship between the people and their livestock. Furthermore, although the murrah (buffalo) is rapidly replacing the domestic water buffalo, due to its higher milk yield, across Southeast Asia, the latter remains predominant in the area.