Purpose: This study aimed to investigate the predictive value of VTIQ and CEUS parameters in determining the load of ipsilateral axillary lymph node metastasis in T1 stage breast cancer. Methods: The study selected 175 lumps from 167 patients with breast cancer confirmed by pathology in our hospital. VTIQ and CEUS were used to evaluate the lesions. The correlation between ultrasonic characteristics and axillary lymph node metastasis in low load group (≤ 2 axillary lymph nodes) and the high load group (>2 axillary lymph nodes) was compared through univariate and multivariate logistic analyses. And the nomogram model was then constructed. The receiver operating characteristic curve, calibration curve and decision curve were used to evaluate the sensitivity, accuracy and applicability of the nomogram. Results: Multivariate logistic analysis revealed that the maximum shear wave velocity, peak time, enhancement intensity, and filling defect sign were independent determinants of axillary lymph node metastasis burden. The area under the curve of the column chart constructed based on these factors was 0.938, indicating good discriminative ability; The calibration curve reveals a good overlap between the predicted curve and the actual observation curve, implying good model calibration; The decision curve indeed indicated high clinical applicability. Conclusions: The nomogram model based on VTIQ and CEUS parameters could effectively estimate the likelihood of axillary lymph node metastasis in T1 breast cancer, which was helpful to provide reference information for clinical diagnosis and prognosis evaluation.