Paediatric breast problems can be categorized into three types. Firstly, they may present as congenital lesions. Also, they can present as part of normal breast development (developmental lesions) which can be subdivided into pre- or post-pubertal lesions. In addition, they can also develop secondary to a neoplastic process. Fortunately, most breast problems in children are benign, and many are self-limiting. Evaluation of breast problems in children starts with a thorough history and examination. Most congenital problems and those related to physiologic breast changes are clinically diagnosed and do not require any further investigation. For discretely palpable masses, ultrasound is the investigation of choice. Masses arising in adolescence, large masses with a rapid rate of progression, those with persistent pain, bloody nipple discharge, and any distortion in breast contour require in addition to an ultrasound, a biopsy to rule out malignancy. Pediatric breast disorders, though largely benign, present a diverse clinical spectrum requiring careful evaluation. This chapter offers a structured approach to understanding and managing breast conditions in children, classifying them as congenital, developmental (pre- and post-pubertal), or neoplastic. It details specific presentations, highlighting their typical course and differential diagnoses. The discussion underscores the importance of history and physical examination, with ultrasound as the key imaging modality. Management strategies, from reassurance and watchful waiting for the majority of children to surgical intervention for some conditions like virginal hypertrophy or suspicious masses, are briefly addressed, guiding clinicians in optimal patient care.