〔Abstract〕 Objective To analyze the value of magnetic resonance diffusion weighted imaging (DWI-MRI) combined with full-field digital mammography (FFDM) in the qualitative diagnosis of breast lesions. Methods 86 patients with breast lesions treated in the First Affiliated Hospital of Xiamen University from April 2019 to March 2021 were examined by DWI-MRI and FFDM separately and jointly. Taking pathological diagnosis as the gold standard, the results of DWI-MRI and FFDM alone and jointly and the types of breast lesions were counted, the diagnostic efficacy was compared, and the apparent diffusion coefficient (ADC) of breast lesions with different b values were analyzed. Results The diagnostic accuracy and sensitivity of DWI-MRI combined with FFDM were higher than DWI-MRI and FFDM alone, and the missed diagnosis rate was lower than DWI-MRI and FFDM alone (P < 0.05). The ADC values of malignant lesions with b = 400 s·mm-2, b = 800 s·mm-2 and b = 1000 s·mm-2 were lower than those of benign lesions (P < 0.05). Conclusion The application of DWI-MRI combined with FFDM in the differential diagnosis of breast lesions can improve the accuracy and sensitivity, reduce the missed diagnosis rate, provide detailed information of lesions, and contribute to the formulation of clinical diagnosis and treatment plan and prognosis evaluation.