Calcifications in the breast are often benign but may also indicate malignant change in the breast. Identifying and characterizing calcifications is an important art and science of breast imaging. In this chapter we discuss the clinical impact of breast calcifications, pathophysiology of benign and malignant calcifications and assessment of calcifications on various imaging modalities. As calcifications are best demonstrated on mammography, we will discuss in detail the appearances on mammography including the typically benign features of some calcifications and also delve into assessment of suspicious calcifications. Classifying suspicious calcifications into various BI-RADS assessment categories to enable appropriate management of calcifications has also been discussed. Biopsy and localization of calcifications and the importance of radiology-pathology correlation have also been addressed. Artefacts mimicking calcifications, disappearing calcifications and prognosis prediction using calcifications have also been touched upon. With scientific progress and successful experiments using the concept of Raman spectroscopy, there are interesting future possibilities of detection and investigation of calcifications in the breast, which we discuss briefly. This chapter provides an overall understanding of breast calcifications with an emphasis on radiological assessment and management of these very important indicators of breast disease.