Objective To analyze the relationships and the differences between the characters of contrast enhanced ultrasound (CEUS) and vascular mimicry (VM) in breast cancer. Method 152 breast cancer patients confirmed as invasive ductal carcinoma by pathology between January 2015 and December 2018 were enrolled. The B mode ultrasound and CEUS were performed before surgery. The CD34/PAS staining were conducted with the specimens after surgery. The clinicopathologic parameters (age, tumor size, clinical stage, axillary lymph node metastasis) and characters of CEUS (enhancement homogeneity, with or without perfusion defect, enhancement degree, enhancement morphology, enhancement margin type, ect) were recorded. t test andΧ_² test were used to analyze the relationship between CEUS characters and VM positive or negative statues. ROC curve was used for analyzing the diagnostic performances of significant factors of VM positive statue. Results The VM positive rate was 26.3% (40/152). The tumors with diameter ＞2 cm, clinical stage of Ⅲ and Ⅳ, and lymph node metastasis were associated with VM positive lesions (P＜0.05). The CEUS characters of tumors with irregular morphology, irregular margin, fast enhancement in the arterial phase and fast disappear in the delayed phases were associated with VM positive lesions (P＜0.05). The irregular margins of the tumors resulted in highest area under the curve (AUC) of 0.764, with the accuracy, sensitivity and specificity of 85.0%, 66.7% and 90.3%, respectively. Conclusions CEUS is relative to VM positive statue. The characters of tumors with irregular morphology, irregular margin, fast enhancement in the arterial phase and fast disappear in the delayed phases suggested the positive statue of VM, which could be a useful supplementary method for differentiating VM positive statue.