Aim: To compare the Needle Aspiration vs Incision and Drainage of Lactational Breast Abscess. Methods: This prospective study was conducted on 100 patients with the primary diagnosis of lactational breast abscess were included in this study. The patients were then divided into two treatment groups A and B with 50 patients in each group. Patients with abscesses of size < 5cm and lactational breast abscess were included in the study. Patients with comorbid conditions were excluded from the study. Results: Our study reported a total of 60 abscesses in the lower quadrant. Even if the abscess was located in more than one quadrant, we had considered that quadrant of the abscess which had the maximum diameter. In the study 54% of the patients were primipara and 46% were multipara. Maximum number of patients (62) had Lower Segment Caesarean Section. In our study more number of patients were presented within the first 6 weeks (86%). In our study we had noticed 64% of the abscesses grow Methicillin resistant Staphylococcus aureus(MRSA).This is followed by Staphylococcus aureus (24%). Other organisms identified in the culture are Corynebacterium diphtheria, S.agalactea and S.epdermidis. The mean duration of healing in group A and group B was 19 days and 30 days respectively. Out of 50 patients in group A only 43 were successfully treated by aspiration. In group B all the 50 patients were treated by incision and drainage. The failure rate of aspiration was 14%. Conclusion: We concluded that the breast abscess in patients with diameter of less than 7 cm can be treated with needle aspiration successfully and with a good cosmetic outcome.