Abstract: Objective To evaluate the clinical value of color Doppler ultrasound and ultrasonic elastography in the differential diagnosis of benign and malignant breast diseases. Methods The clinical data of 131 cases of breast lesion were analyzed retrospectively.Accuracy, specificity and sensitivity of were calculated for color Doppler ultrasound and ultrasonic elastography, considering the pathological diagnosis as the gold standard.Kappa consistency test was performed to measure the inter-rater reliability.Kappa over 0.75 as excellent, 0.40 to 0.75 as fair to good and below 0.40 as poor. Results Pathological results showed that there were 150 niduses with the diameter of 7.1-43.2 mm among 131 patients.There were 85 cases of benign lesion with 97 niduses, including 61 niduses in breast fibroadenoma, 15 niduses in mammary gland inflammatory lesion, 13 niduses in mammary gland hyperplasia, 3 niduses in intraductal papilloma, 2 niduses in fibrolipoma, 2 niduses in duct ectasia, 1 nidus in atypical hyperplasia.There were 46 cases of malignant lesion with 53 niduses, including 39 niduses in invasive ductal carcinoma, 5 niduses in intraductal carcinoma, 3 niduses in lobular carcinoma in situ, 3 niduses in invasive lobular carcinoma, 2 niduses in medullary carcinoma, and 1 nidus in mucinous adenocarcinoma.The accuracy, sensitivity and specificity for color Doppler ultrasound was 79.4%, 78.3% and 80.0%, respectively, Kappa=0.563;while the accuracy, sensitivity and specificity for ultrasonic elastography was 88.5%, 87.0% and89.4%, respectively, Kappa=0.752. Conclusion The ultrasonic elastography have advantages over color Doppler ultrasound in the differential diagnosis of benign and malignant breast diseases.