Benign breast diseases are less common in the geriatric population compared to the younger population. While some of these diseases have classical features indicating benignity and no further evaluation is required, some have overlapping features indistinguishable from malignancy and pose a diagnostic challenge to radiologists. The clinical presentation, imaging features, and management of benign breast diseases such as epidermal inclusion cyst, cysts, fat necrosis, hamartoma, fibroadenoma, mammary duct ectasia, intraductal papilloma, lipoma, surgical scar, and gynecomastia in this older age group are covered.