Background <p>Breast cancer (BC) is a leading cause of cancer-related deaths among women in Afghanistan, with an age-standardized mortality rate of 16.9 per 100,000, significantly higher than the global average of 11.0. It accounts for 27.7% of newly registered cancer cases, highlighting the urgent need for improved awareness, early detection, and access to treatment. This study assessed BC awareness among women in Kabul to identify knowledge gaps and inform interventions.</p> Methods <p>A hospital-based cross-sectional study was conducted among 485 women aged 30 and above at the Ariana Medical Complex in Kabul. Data were collected using the validated Breast Cancer Awareness Measure (Breast CAM), adapted into Dari, through face-to-face interviews. Descriptive statistics and linear regression analyses were used to evaluate awareness levels and identify predictors of knowledge.</p> Result <p>The study revealed alarmingly low awareness levels, with 55.4% of participants unable to name any BC early warning signs and 56.7% unable to identify any risk factors in open-ended questions. Only 12.8% correctly identified age as a significant risk factor. Key risk factors, including obesity, physical inactivity, and genetic predisposition, were poorly recognized. Despite high confidence in detecting breast changes, 52.4% rarely or never perform self-examination. Higher education and family history of cancer were positively associated with awareness (<i>p</i> &lt; 0.05), while higher income showed a trend toward a negative association (<i>p</i> = 0.057).</p> Conclusions <p>The findings highlight a critical gap in BC awareness among Afghan women, emphasizing the need for targeted educational campaigns, improved access to screening, and strengthened healthcare infrastructure.</p>