Background: Conservative breast surgery is crucial for breast cancer. Technique choice, like MRM and Reduction Mammoplasty, impacts cosmetic outcomes and patient quality of life. This aimed to compare outcomes of MRM and Reduction Mammoplasty respect to cosmetic results, postoperative complications, and overall patient satisfaction in breast cancer not responding to neoadjuvant chemotherapy. Methods: This comparative prospective wconducted on 30 breast cancer who met inclusion criteria. Fifteen were assigned to each group, one undergoing MRM axillary clearance and other undergoing Reduction Mammoplasty axillary clearance. All provided written informed consent and were thoroughly counseled regarding procedures and potential outcomes. Results: Reduction Mammoplasty wassociated a significantly longer mean operative time (2.7 ± 0.465 hours) compared to MRM (1.9 ± 0.425 hours). However, there wno statistically significant difference in intraoperative blood loss between two groups. Postoperative hospital stays were comparable, Group (1) (MRM) staying 1 to 3 days and Group (2) (Reduction Mammoplasty) staying 1 to 2.5 days. found similar rates of postoperative surgical complications, including wound infection, hematoma, and wound dehiscence, between two groups. : Both techniques, MRM and Reduction Mammoplasty, are viable for breast cancer not responding to neoadjuvant chemotherapy, comparable outcomes and complications.