〔Abstract〕 Objective To investigate the value of multimodal magnetic resonance imaging (MRI) in the differential diagnosis of benign and malignant breast mass-like lesions. Methods A total of 104 patients with breast lump-like lesions admitted to the First Affiliated Hospital of Henan University of Chinese Medicine from August 2020 to October 2021 were retrospectively analyzed. All patients had complete multimodal MRI data and pathological data. To analyze the value of multimodal MRI in the differential diagnosis of benign and malignant breast mass lesions and the consistency with the gold standard with pathological results as the gold standard, and to compare the multimodal MRI features of benign and malignant breast mass-like lesions. Results The results of multimodal MRI were in good agreement with pathological results (κ = 0.860). The accuracy, sensitivity, specificity, positive predictive value and negative predictive value of multimodal MRI for breast lump-like lesions were 93.26 %, 98.33 %, 86.36 %, 90.76 % and 97.43 %, respectively. The detection rates of irregular shape and burr sign, uneven enhancement and ring enhancement, effusion time-signal intensity curve (TIC) and low apparent diffusion coefficient (ADC) in malignant breast mass lesions were higher than those in the benign breast mass-like lesions, and the differences were statistically significant (P < 0.05). Conclusion Multimodal MRI has high diagnostic value in differentiating benign and malignant breast mass lesions.