Bovine trichomoniasis is a sexually transmitted protozoan disease with a worldwide distribution. It has been endemic in the USA for more than 80 years. Mississippi and all the states west of the Mississippi River, except Iowa and Minnesota, have rules/regulations to reduce the spread of the disease. The core of these regulations consists of testing bulls and prohibiting importation of non-Tritrichomonas foetus-free bulls. Factors such as sampling methods and intervals, shipping medium and temperature, and testing techniques are reviewed for their effect on diagnostic accuracy. Finally, a comprehensive approach for controlling and eventually eradicating the disease is presented.