Background: Mastectomy leads to moderate to severe degrees of depression and anxiety. Objectives: This study aimed to evaluate the outcome of breast conservative surgery with breast reconstruction on the quality of life (QOL). Patients & methods: The current retrospective study included 62 patients with T1, and T2 breast cancer who underwent modified radical mastectomy (MRM) or breast conservative surgery (BCS) with reconstruction. Evaluation of the quality of life, depression as well as post-operative complications was reported and compared. Results: The current study included 62 female patients with mean age of 43.20 ± 4.49 and 44.36 ± 5.16 in groups A and B respectively. There was a significantly lower mean operative time (P value =0.001) in patients who underwent MRM. There was statistically significant beck depression inventory (BDI) scores in both groups with more improvement in BCS group. Both groups reported statistically significant improvement of psychological well-being, social well-being, and spiritual well-being after 6 months with significant improvement in group A. Conclusion: Conservative breast surgery with reconstruction offers an oncologically safe alternative for modified radical mastectomy with less impact on the QOL and associated with less depression