A great problem was evoked about the imported Indian buffalo meats which were used to compensate the decrease in the meat industry in Egypt. This is due to the infection of the Indian meat with Sarcocystis species specially the prevalent macroscopic S. fusiformis. Therefore, we planned this work in order to update the prevalence and distribution patterns of S. fusiformis infecting the Egyptian water buffaloes, as well as studying their ultrastructure. Tissue specimens from esophagus, heart, tongue, diaphragm and throat muscles were recovered from 550 water buffaloes slaughtered at Mansoura abattoir in Dakahlia Province, Egypt, during the period between July 2009 and June 2010. S. fusiformis cysts were recovered from 58.72% of the examined animals. The infection rate was higher in aged buffaloes than young ones. The prevalence of infection was 100% in the esophagus, while no infection was detected in the heart. Ultrastructurally, the cyst wall was thin (1-3µm) exhibiting highly branched and anastomosed cauliflower-like villar protrusions.