The problem of breast hypertrophy is increasing world wide, especially in our part of the Middle East. Large breasts may be embarrassing and properly fitting clothes may be difficult to find. The breast may be chronically tender, and tension by the brassiere straps may cause furrowing of the shoulders. The leverage of the weight by the front of the chest may lead to chronic stooping of the shoulders, tiredness in the neck and back pain. Any of these problems constitutes sufficient reason for reducing the size and weight of the breast. This review dealt with this problem and the most popular and recent techniques used for reduction mammaplasty with the advantages and disadvantages of each technique and the common complications and how to avoid them