Objective To explore and compare ultrasonic imaging characteristics in breast cancer patients with different molecular subtypes. Methods A retrospective analysis was performed on the 130 patients with breast cancer admitted to the hospital between March 2019 and March 2021. According to the results of immunohistochemistry, they were divided into luminal A group (Luminal A, n=38), luminal B group (Luminal B, n=41), triple-negative group (n=29) and proto-oncogene human epidermal growth factor receptor 2 (HER-2) overexpression group (n=22). The clinical data, imaging characteristics and pathological characteristics in the four groups were recorded and compared. The relationship between pathological characteristics and imaging characteristics was analyzed. Results There were significant differences in histological grading, lymph node metastasis, tumor diameter, tumor boundary, echo types, posterior echo, tumor morphology, tumor calcification and blood flow grading among the four groups (P<0.05). The main ultrasonic imaging characteristics in Luminal type included spicule sign, low echo, no calcification, irregular morphology and grade 0-I blood flow. The main ultrasonic imaging characteristics in triple-negative type included micro-lobulation sign, low echo, posterior echo enhancement, irregular morphology, no calcification and grade II-III blood flow. The main ultrasonic imaging characteristics in HER-2 overexpression type included blurred sign, low echo, posterior echo enhancement, irregular morphology, calcification and grade II-III blood flow. There were significant differences in blood flow and tumor morphology among patients with breast cancer at grades I, II and III (P<0.05). Conclusion There are certain ultrasonic imaging characteristics and pathological characteristics in breast cancer patients with different molecular subtypes. Clinically, molecular subtypes can be determined according to imaging characteristics and pathological characteristics. Individualized treatment regimens can be selected based on these to improve prognosis and prolong patients survival.