Objective: To investigate the application value of ultrasound-guided vacuum-assisted 8-gauge Mammotome biopsy system (UVMS) in diagnosis and treatment of breast masses. Methods: The clinical data of 1 157 patients with breast masses (a total of 3 702 lesions) undergoing UVMS treatment from January 2012 to December 2013 were retrospectively analyzed. Results: All lesions were removed by UVMS. Among the 1 157 patients, 888 cases (76.75%) had no palpable mass, 831 cases (71.82%) had multiple lesions, and 245 cases (21.18%) had bilateral lesions. The average longitudinal diameter of the lesions was 11.2 (3–35) mm, the average operative time was 15 (3–90) min, the average blood loss was 8 (1–40) mL, and the length of incision ranged from 3 to 5 mm. The majority of the specimens (99.57%) were pathologically diagnosed to be benign lesions, in which fibroadenoma was the dominant one (64.61%). After operation, hematoma occurred in 53 cases, subcutaneous ecchymosis occurred in 26 cases, bloody nipple discharge in 2 cases, and no other severe complications were observed. Conclusion: The application of UVMS for removal of breast masses is simple, safe and minimally invasive, and is especially suitable for multiple and impalpable masses, but the indications should be strictly controlled.