Objective To explore the value of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) quantitative permeability parameters combined with magnetic resonance diffusion-weighted imaging (DWI) in the diagnosis of benign and malignant breast lesions. Methods The clinical data of 64 patients with breast lesions (45 cases of invasive ductal carcinomas, 19 cases of fibroadenomas) confirmed by operation and pathology in the hospital during December 2016 to December 2017 were analyzed retrospectively. 20 cases with normal breast were selected as the control group at the same time. All cases were examined by 3.0T MRI plain scan, DWI (diffusion-sensitive factor b=1000s/mm2 ) and DCE-MRI at 1 week before operation. The apparent diffusion coefficient (ADC value) and the volume transfer constant (Ktrans value) of the lesion were measured. The pathological results were obtained after operation or puncture. Results There were statistically significant differences of ADC value and Ktrans value between invasive ductal carcinoma and fibroadenoma, between invasive ductal carcinoma and control group, between fibroadenoma and control group (P<0.05). With pathological results as the golden standard, the sensitivity, specificity and accuracy of ADC value combined with Ktrans value in differentiating benign and malignant breast lesions were higher than those of ADC value or Ktrans alone. Conclusion The combined diagnosis of DCE-MRI quantitative permeability parameter Ktrans value and DWI quantitative analysis ADC value not only can reflect the tumor morphological information, but also can reflect information such as the tumor cell level and vascular functional, and improve the value of qualitative diagnosis of benign and malignant breast lesions, which provides new ideas for clinical treatment for patients.