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Background: Esophageal groove dysfunction is one of the major causes of ruminal bloat. This condition is fatal in new born calves if it is not treated early. In healthy, suckling calves, milk should bypass the forestomach (rumen and reticulum) and enter into the abomasum where enzymatic digestion of milk proteins takes place. However, failure of the esophageal groove allows milk to enter into the forestomach, which results in the production of excess gases by microbial fermentation. Consequently, this increase in abdominal distention particularly on the left side in ruminants is an imminent manifestation of excess gases in the foresomach. Case presentation: A 10-day-old crossbred male calf presented with a distended left abdomen and manifesting dyspnea at a dairy farm. The calf was weak, reluctant to move, and had visibly congested mucus membranes. Regarding the calf’s feeding, milk was the only thing ingested and the calf had not started on dry feeds (hay, concentrates, and roughages). According to the herdsman of the farm, the calf had a mild-to-moderate form of bloat and 3–5 h after milk feeding the bloat would disappear spontaneously. During bloat, an increase in pulse rate, respiratory rate (tachypnea), and shallow breathing was noted. Physical examination revealed severe distention of the left side of the abdomen, and on percussion, accumulation of gases mixed with fluid in the left abdomen was detected. An attempt was made to release gases from forestomach by introducing a stomach tube with oral antibiotics; however, the case was not resolved. The calf suffered from frequent recurrence of bloat after every milk feed, and in response to the refractory outcome to conventional treatment, a rumenostomy was indicated and a better treatment response was achieved. In addition, IV fluid and other supportive therapy were provided while milk was withheld. However, considering the fact that milk is a natural feed that should not be taken away from every calf at this age, we had to encourage calf to consume milk as it would not result in bloat as far as rumen fistula is being created. Furthermore, encouraging calves to consume starter feed (fresh grasses and hay) earlier than usual recommended period whilst decreasing milk intake would hasten the rumen function. Conclusions: Cases like this are successfully managed by a rumenostomy when conventional options fail. [ABSTRACT FROM AUTHOR]