Purpose: The purpose of this study is to assess the role of dual energy contrast enhanced digital mammography in evaluation and characterization of breast lesion in edematous breast. Material and methods: 30 female patients (with 32 edematous breasts) were enrolled in the study their age ranged between 29-80 years old. All presented with breast edema in conventional mammography. All were subjected to Dual-energy contrast enhanced digital mammography, Pair of low- and high-energy images were acquired after contrast injection using a modified full-field digital mammography system , then the two images were combined to enhance areas of contrast uptake. The nonionic iodinated contrast agent was administered manually into the contralateral antecubital vein. The results were compared to the sono-mammography and cases were histopathological proven. Results: 26 /32 of our cases were histopathological proven as malignant and 6/32 was benign. An area of enhancement was depicted on contrast-enhanced digital mammograms (CEDM) in 24/26 histologically proven malignant related breast edema, compared to 22/24 by conventional mammography alone. However multicentricity was better detected after contrast injection. Our results show that the sensitivity of CEDM was 92% vs. 77% and 88% for MX and US respectively; while specificity for CEDM was 100% vs.85% and 66% for MX and US respectively. Also the good diagnostic accuracy of CEDM+ MX for the detection of breast carcinoma, which here superior to mammography alone and to ultrasound alone or combined both mammogram with ultrasound. Conclusion: The addition of dual energy contrast enhanced digital mammography technique to Conventional Sonomammography can significantly improve the detection of underlying breast lesions in edematous breasts, the determination of the extent of disease, the assessment of chemotherapeutic response and follow up of post conservative breast surgery and radiotherapy.