Objective To investigate the clinical value of MRI in differential diagnosis of benign and malignant breast lesions. Methods The clinical data of 80 patients with breast lesions in our hospital were examined by MRI. With the pathological diagnosis as the golden standard, the sensitivity, specificity and accuracy of MRI in the diagnosis of benign and malignant lesions were statistically analyzed. The shapes, edges, enhancement and involvementof benign and malignant lesions were observed and recorded. The early enhancement rate, the maximum enhancement rate and the maximum relative enhancement rate of benignand malignant lesions were also statistically analyzed. Results Among 80 cases, there were 46 cases with benign lesions and 34 cases with malignant lesions confirmed by surgery and pathology. The sensitivity, specificity and accuracy of MRI in the differential diagnosisof benign and malignant breast lesions were 90.48%, 88.24% and 85.00% respectively. The proportions of irregular shape, rough edges, burr, nodule or mass like enhancementand involvement of surrounding tissues of malignant breast lesions were significantly higher than those of benign lesions(P<0.01).The early enhancement rate, the maximum enhancement rate and the maximum relative enhancement rate of malignant breast lesions were significantly higher than those of benign lesions (P<0.01). Conclusion MRI imaging features of benign and malignant breast lesions are significantly different, especially the enhancement rate of malignant lesions is significantly higher. Thus, MRI is with high sensitivity, specificity and accuracy in the differential diagnosis of benign and malignant breast lesions.