Breast anomalies in pediatric population are common; fortunately, vast majority of these conditions are benign. The spectrum of breast disorders in pediatric population is different from those in adults, and often different treatment options are involved. Evaluation of breast-related symptoms in children includes a thorough history and physical examination, with breast sonography generally serving as the primary imaging modality. There is lack of comprehensive categorization of these abnormalities. Breast anomalies in pediatric population can be roughly classified into four groups: hyperplasia (premature thelarche, virginal hypertrophy-gigantomastia, polymasty, polythelia, breast masses (tumors, non-tumorous masses, gynecomastia), hypoplasia (athelia, hypomasty, amastia, amazia, Poland’s syndrome, tuberous breasts), asymmetry, and deformation (burns, traumatic lacerations, dog bites, and iatrogenic breast bud damage by surgical procedures). Each patient with any of these breast conditions requires individualized approach and treatment with maximal precautions.