By definition, direct methods for early pregnancy diagnosis of dairy cattle involve direct detection of the tissues and/or associated fluids of the conceptus either manually or via electronic instrumentation. Currently available direct methods for diagnosis of pregnancy include transrectal palpation and B-mode ultrasonography, and both methods are currently used by bovine practitioners to diagnose pregnancy in dairy cattle. Because they are direct methods, the test outcome can be subjective among practitioners. Technical expertise, operator proficiency, and the stage post breeding that the technique is performed can affect the specificity and sensitivity of the test. However, experienced practitioners can achieve acceptably high sensitivity and specificity with either method.