The objectives of this study were to compare the effectiveness of different indicators of mammary inflammation in buffalo and to evaluate the association of the indicators with buffalo milk yield, composition, and rennet coagulation properties. This study was carried out at four buffalo farms in central Italy using a total of 50 lactating buffalo. Milk from each buffalo was tested at the beginning, middle, and end of lactation. To evaluate the relationship between mastitis markers and milk components, three classes were defined for each of the following markers: total somatic cell count (TSCC), differential somatic cell count (DSCC), and bacteriological results The regression coefficient for the reference method and the alternative method of determining TSCC was 0.81, indicating that the method routinely used to analyze buffalo milk consistently underestimated actual TSCC. The milk samples positive for udder-specific bacteria also had higher TSCC values than the samples that were negative for bacteria ($872{ imes}10^3$/ml vs. $191{ imes}10^3$/ml). In samples that were positive for udder-specific bacteria, polymorphonuclear leukocytes (PMN) made up greater than 50% of the cells. Moreover, only 1% of the samples in the lowest TSCC class were positive for bacteria. The correlation between TSCC and PMN was stronger (0.70), and PMN values in buffalo milk increased significantly when the TSCC class changed from low (38%) to medium and high (56% and 64%). Milk yield was negatively related to TSCC. Significant changes in lactose (4.87%, 4.80% and 4.64%) and chloride content (0.650 mg/ml, 0.862 mg/ml and 0.882 mg/ml) were also observed with increasing TSCC values. Higher TSCC was associated with impaired rennet coagulation properties: the clotting time increased, while the curd firming time ($p{leq}0.05$) and firmness decreased. We concluded that in buffalo as in dairy cows, TSCC is a valid indicator of udder inflammation; we also confirmed that a value of $ 200{ imes}10^3 cells/ml should be used as the threshold value for early identification of an animal affected by subclinical mastitis. In addition to its association with significantly decreased milk yield, a TSCC value above this threshold value was associated with changes in milk composition and coagulating properties.