Simple SummaryPregnancy diagnosis plays an essential role in decreasing days open in dairy farms; therefore, it is very important to select an accurate method for diagnosing early pregnancy. Besides traditional pregnancy diagnoses made by rectal palpation of the uterus from 40 to 60 days after AI and measuring the serum or milk progesterone concentration between 18 to 24 days after AI, there are several new possibilities to diagnose early pregnancy in dairy farms. However, it is very important to emphasize that before introducing any new diagnostic test, we need to make sure the accuracy of that particular test to be able to decrease the rate of iatrogenic pregnancy losses caused by prostaglandin or resynchronization treatments. This review focuses on the diagnostic possibilities and limitations of early pregnancy diagnosis in the field.One of the most recent techniques for the on-farm diagnosis of early pregnancy (EP) in cattle is B-mode ultrasonography. Under field conditions, acceptable results may be achieved with ultrasonography from Days 25 to 30 post-AI. The reliability of the test greatly depends on the frequency of the transducer used, the skill of the examiner, the criterion used for a positive pregnancy diagnosis (PD), and the position of the uterus in the pelvic inlet. Non-pregnant animals can be selected accurately by evaluating blood flow in the corpus luteum around Day 20 after AI, meaning we can substantially improve the reproductive efficiency of our herd. Pregnancy protein assays (PSPB, PAG-1, and PSP60 RIA, commercial ELISA or rapid visual ELISA tests) may provide an alternative method to ultrasonography for determining early pregnancy or late embryonic/early fetal mortality (LEM/EFM) in dairy cows. Although the early pregnancy factor is the earliest specific indicator of fertilization, at present, its detection is entirely dependent on the use of the rosette inhibition test; therefore, its use in the field needs further developments. Recently found biomarkers like interferon-tau stimulated genes or microRNAs may help us diagnose early pregnancy in dairy cows; however, these tests need further developments before their general use in the farms becomes possible.