〔Abstract〕 Objective By analyzing the imaging features of Paget's disease of the breast, the detection rate and understanding of this disease can be improved. Methods A retrospective analysis was performed on 68 patients diagnosed with Paget's disease pathologically from three hospitals from January 2000 to June 2022, including 59 patients who met the inclusion and exclusion criteria. Descriptive statistics were used to analyze their clinical, X-ray, ultrasound, magnetic resonance imaging (MRI) and pathological features. Results Among 59 patients with Paget's disease, 59 patients had mammary papilla-areola complex invasion, 8 patients had skin invasion, 55 patients had intramammary lesions, 4 patients had no intramammary lesions, and 15 patients had axillary lymph node metastasis. There were 19 cases of ductal carcinoma in situ, 16 cases of invasive ductal carcinoma, and 20 cases of invasive ductal carcinoma complicated with carcinoma in situ. Molecular classification included Luminal A type (12 cases), Luminal B type (9 cases), human epidermal growth factor receptor-2 (HER2) overexpression type (32 cases), and three negative type (2 cases). X-ray is superior in detecting calcification foci. Ultrasound was superior in the evaluation of tumor, papillary areolar invasion and lymph nodes. MRI has advantages in the evaluation of papillary areola invasion and non-mass lesions. Conclusion The combination of clinical features, X-ray, ultrasound and MRI is of great significance in the diagnosis of Paget's pathology of breast.