Papillary breast neoplasms show a wide spectrum of pathologic changes, and the hallmark of these tumors is the presence of a fibrovascular core. Histologically, papillary breast neoplasms can be broadly divided into benign papillomas, atypical papillomas, and malignant papillary lesions. The papillary breast neoplasms have been described as having a varied appearance, but review of the imaging spectrum is limited. The purpose of this article is to review the characteristic sonographic features of the broad spectrum of papillary breast neoplasms from benign papillomas to malignant papillary lesionsope