Background: On U/S, a hyperechoic breast mass is defined as a lesion that is of increased echogenicity compared to the subcutaneous adipose tissues. Approximately 0.6–5.6% of breast masses are hyperechoic. The aim of the work was to assess the diagnostic value of US of echogenic is valid for proper diagnosis comparing with histopathological findings as a gold standard. Methods: This was a prospective study was done on cases at Benha university hospital radiology department. Our study included 50 cases in whom US revealed suspicious masses of these patients. Results: According to diagnosis based on ultrasonography  11 (22%) patients with Lipoma, 8 (16%) patients with Hamartoma, 7  (14%)  with Mastitis 5 (10%) with Intramammary lymph nodes, 3 (6%) with  Fat Necrosis, 4 (8%) with Fibroadenoma, 1 (2%) with  Seroma, 3 (6%) with Fibrocystic breast condition, 3 (6%) with Adenoma , 1 (2%) with Angiosarcoma and no patient showed Primary cancer as a provision diagnosis. While final diagnosis showed  11 (22%) patients with Lipoma, 6 (16%) patients with Hamartoma, 6 (26%)  with Mastitis 5 (10%) with Intramammary lymph nodes, 3 (6%) with  Fat Necrosis, 5 (10%) with Fibroadenoma, 1 (2%) with  Seroma, 3 (6%) with Fibrocystic breast condition, 4 (8%) with Adenoma , 1 (2%) with Angiosarcoma and one (2%) patient showed Primary cancer. According to validity of ultrasonography in diagnosis of different echogenic breast lesions, it was 100% accurate in all types of lesions except 3 lesions (2 cases of hamartoma and one case of mastitis) which finally diagnosed as (Adenoma , Angiosarcoma and Primary breast cancer). Conclusion: We can conclude that Hyperechogenicty  appearance of breast lesion by US is enough to exclude malignancy while hypoechgenic and other types of breast lesions needs further investigations for excluding malignancy. Other US BI-RADS categories is necessary to differentiate the types of breast of lesion.