Heartwater disease is a tick-borne illness primarily affecting ruminant animals. Also known as Cowdriosis, this devastating ailment can lead to severe consequences if left untreated. Synonyms for Heartwater disease are Ehrlichiosis, Ntengo, and Pernicious fever. Ehrlichiosis refers to the bacterial infection caused by Ehrlichia ruminantium, the pathogen responsible for Heartwater disease. Ntengo, a term commonly used in Southern Africa, reflects the native Xhosa name for the disease. Additionally, Pernicious fever signifies the relentless fever that accompanies this condition. Understanding these synonyms is crucial for early recognition and effective management of Heartwater disease, as it promotes better communication and collaboration within the veterinary field.