This paper discusses the diagnosis and treatment of an umbilical abscess in a 6-year-old dairy cow. The patient was medically managed for a presumptive diagnosis of an umbilical abscess by the referring veterinarian (rDVM) with antibiotics and wound flushing but the draining tract did not improve. The cow presented to Cornell’s Large Animal Hospital on November 15th, 2020, and was taken to surgery in dorsal recumbency for removal of the abscess on November 18th, 2020. She was unstable under anesthesia and the procedure was aborted. Aggressive medical management in hospital for 5 weeks failed to resolve the draining tract. A second surgery in lateral recumbency on December 23rd, 2020, allowed subtotal resection and debridement of the umbilical abscess. Postoperative cellulitis and edema developed and the wound was treated with flushing and packing with Kerlix-soaked gauze. The cow was discharged before complete healing, but updates from the rDVM indicated she recovered well.