Objectives Aimed to evaluate the value of ultrasound BI-RADS category on breast nodules of different breast ultrasound types. Methods Through searching the electronic medical record system for hospitalization and surgery for breast nodules in our hospital from June 2014 to April 2016, three hundred and five cases were selected for analysis with complete preoperative ultrasonography data, clear ultrasound BI-RADS category and postoperative pathological results. These patients were 16 to 76 years old, with average age of 56±18 years old. According to the whole sonographic features of breast tissue, the breasts were divided into glandular type, gland fiber typeⅠ, gland fiber type Ⅱand fat type. Ultrasound BI-RADS category on breast nodules followed the American College of Radiology guidelines. The pathology results were as the gold standard, which were classified into benign and malignant. The number of various BI-RADS category of the breast nodules were counted in different ultrasound types and the data were analyzed by SPSS19.0 for ROC analysis. Results Area under the ROC curve of BI-RADS category was 0.963 in a whole. Area under the ROC curve of BI-RADS category on nodules in different breast ultrasound types was as follows respectively: 0.933 (glandular type), 0.902 (gland fiber type I), 0.953 (gland fiber type II), and 0.989 (fat type). The benign and malignant cutoff points were between 4b and 4c of ultrasound BI-RADS category in different breast ultrasound types. Conclusions Ultrasound BI-RADS category had good diagnosing validity on breast nodules in different breast ultrasound types, and the best cut-off points of ultrasound BI-RADS category were consistent in different ultrasound types of breast.