Axillary treatment in early breast cancer entails surgical addressal of axillary nodes or radiation therapy. Localization and targeted removal of axillary nodes help to avoid the complications of routine axillary lymph nodal dissection, which is otherwise associated with increased limb morbidity. Besides intraoperative sentinel lymph node biopsy, which is the gold standard localization technique that has been used for a long time, preoperative imaging can serve as a less invasive alternative in the detection of axillary and extra axillary nodal bulk. Imaging guided biopsy or aspiration cytology, marking of suspicious lymph nodes for post-chemotherapy assessment are added advantages that can help to decide on further management. In this chapter, we elaborate the axillary nodal anatomy, various imaging modalities and their utility in detection, staging, localization, and targeted removal of suspicious axillary lymph nodes in patients with breast cancer.