The male breast is a rudimentary structure composed predominantly of adipose tissue and atrophic ductal tissue in the subareolar region, as compared to developed terminal ductal-lobular units and the ductal system in female breast. The male breast diseases are rarer and different from the female breast and therefore need understanding of basic anatomy and pathologies separately. The majority of male breast pathologies are benign, the most common being gynecomastia. Male breast cancer is very rare, and invasive ductal carcinoma is the most commonly seen histologic subtype. The incidence of lobular diseases such as fibroadenomas, phyllodes, sclerosing adenoses, fibrocystic disease, and lobular carcinoma is very low in men compared with women because men do not have terminal ductal-lobular unit differentiation. Diseases arising from the skin and subcutaneous tissue are also common in the male breast. There is no standardized imaging algorithm or screening protocol, so all imaging assessment in men are mostly diagnostic in nature. Mammography and ultrasound are the two main imaging modalities used to evaluate the male breast. Although male breast disease is uncommon, it is imperative to understand the differences between male and female breast anatomy and pathologies for making an accurate diagnosis and avoiding unnecessary investigations.