Objective To summarize the ultrasonic image features of adenoid cystic carcinoma of the breast (ACCB), in order to improve the knowledge. Method The ultrasonic images of 14 patients of ACCB confirmed by pathology or needle biopsy were retrospectively analyzed. Result Sonographically, ACCB demonstrated as an irregular mass with noncircumscribed margin and parallel orientation. 10 cases appeared hypoechoic and 4 were complex cystic lesions. 5 cases showed posterior acoustic enhancement and 1 had posterior acoustic shadow with the remaining cases absence of posterior acoustic feature. Microcalcification could be found in 3 cases and architectural distortion in 9 cases. All the masses were with minimal vascularity on color Doppler examination. Conclusion: There were nonspecific imaging features of ACCB by ultrasound, and it was difficult to clarify the diagnosis before operation.