In July 2017, twenty cattle of a free-grazing herd were found to be infested with leeches in the mouth. Main signs were bloody sialorrhea and/or a purple-red colour of the lower lip. Leeches, in a variable number (1 to 3) per animal, were found at the lingual frenulum or on the sublingual vestibular mucosa and were morphologically identified as Limnatis nilotica. To the best of our knowledge, this is the first report of cattle infestation by L. nilotica in Italy. Besides recalling the attention to leech infestation and suggesting its inclusion in the differential diagnosis of animals with suggestive signs, this short report also provides practitioners with easy-going morphological keys for proper diagnosis and discrimination among species.