Objectives: This present study was aimed to compare the clinical outcomes of the two treatment modalities:percutaneous ultrasound guided needle aspirations versus incision and drainage inthe management of breast abscesses. Methods: A total of 50 breast abscess patients were enrolled in this study. All the patients were randomized and allocated into 2 groups of 25 patients each.25 patients in one group were subjected topercutaneous ultrasound guided needle aspiration (Group A) under local anaesthesia and 25 patients in another group to incision and drainage (Group B) under general anaesthesia respectively. A detailed history and clinical examination was done for all the patients and multiple clinical variables were recorded prospectively to evaluate the differences in theclinical outcomes of the two modalities used for the management of breast abscesses. Results: Majority of patients 27(54%) were in the age group of 21-25 years.44% of the patients of group A and 36% patients of group B were found to be febrile. Pain and swelling was universally present in both the groups respectively. Axillary lymphadenopathy in group A was present in 12% patients and in group B in 8% patients. Cracked nipples were seen in 24% patients in group A and 12% patients in group B. Breast feeding was abandonedfrom the diseased breast in only one patient (4%) of Group A due to failure of therapy and in all the patients of Group B. Onlyone patient(4%)in Group B developed milk fistula, a known complication and two patients(8%) developed recurrent breast abscesses . 23patients(92%) were satisfied in Group A and 14 patients(56%) were satisfied in Group B. Conclusions: Ultrasound guided needle aspirationis a safe and cost effective method that does not require hospital admissions, does not require prompt post operative care, does not hamper breast feeding from the diseased breast, gives an excellent cosmetic result and can be done as a day care procedure with a high rate of success. Thus it is a better alternative to surgicalincision and drainagefor the management of breast abscesses.