Bovine trypanosomiasis caused by Trypanosoma vivax is a relevant disease in domestic ungulates in Latin America, causing different types of livestock losses, particularly in African and South American countries, leading to loss of millions of dollars/year related to dairy and meat production. In addition, T. vivax trypanosomiasis requires intensive veterinary care. While vector control is a feasible measure to manage disease spreading, the search for accurate diagnostic tools still represents a gap in routine veterinary practices and a challenge for the scientific community. The parasite is mechanically transmitted by fomites or by the saliva of haematophagous flies, such as Stomoxys sp. and Tabanus sp., infecting cattle as well as a number of animal hosts. The main symptoms of T. vivax bovine trypanosomiasis are apathy, fever, restricted growth, miscarriage, progressive weakness, neurological signs, pale mucous, loss of appetite, lethargy, and substantial weight loss. In most cases, the presence of animals with subclinical infections, nonspecific symptoms and without apparent parasitaemia presents a challenge when making a diagnosis, which requires accurate methods. Herein, we review state of the art concerning current methods available for the diagnosis of T. vivax bovine trypanosomiasis, focusing on clinical, parasitological, immunological and molecular approaches, highlighting the main features of each method, including “pros and cons”. Overall, combining several diagnostic techniques is a better choice since it leads to fewer false negative results and contributes to better disease control.