The aim of the present study was to evaluate the effect of intrauterine ozone insufflation alone or in combination with cephalexin in treating the postpartum clinical endometritis in dairy cows. Fourteen postpartum clinical endometric cows based on the uterine findings and diagnosis were randomly allotted into two groups (each seven in number) and seven postpartum normal cyclic animals were taken as control. Animals in group I were treated with intrauterine ozone insufflation. Group II animals were treated with cephalexin (Lixen-IU®) through intrauterine route in combination with intrauterine ozone insufflation and the animals in control group were not subjected to any treatment regimen. After clinical recovery, the animals were inseminated artificially on exhibition of estrus. Combined mucous character and odour, PMN cell count and bacterial count were assessed on pre and post treatment days and the conception rate was evaluated following first artificial insemination. Following treatment the overall reduction in combined mucous character and odour both in group I (82.04%) and group II (87.25%) were similar and highly significant (p<0.01). The most predominant bacteria found was E. coli (28.57%) followed by Pseudomonas spp. (14.28%), Staphylococcus spp. (21.42%), Streptococcus spp. (21.42%), Proteus spp. (7.14%) and Acinetobacter calcoaceticus (7.14%). Overall reduction in bacterial count on pre (day 1) and post treatment (day 7) were highly significant (p<0.01) i.e. 99.60% in group I and 99.72% group II. PMN cell counts of uterine smear were significantly (p<0.01) increased from pre treatment (25.85±3.28 in group I and 22.85±2.77) in group II) to post treatment (77.71±2.86 in group I and 87.14±1.35 in group II) which indicated the infiltration of neutrophils due to action of ozone and cephalexin. The conception rates following first AI were recorded as 42.85% in group I (3/7) and 71.42% (5/7) in group II. Thus intrauterine ozone insufflation has the potential to alleviate postpartum clinical endometritis as an efficacious, cost effective treatment option and an alternative to antibiotics with an overall improvement of fertility rate in dairy cows.