Objective To summarize the experience of ultrasoundguided guide wire localization and its application value in minimally invasive and accurate resection of non palpable breast masses. Methods The cases of breast UGWL in our hospital in the past 13 years were included. The size, location, surgical results, and pathological types of the lesions were summarized and statistically analyzed. The clinical workflow and operating technical essentials of UGWL were condensed and summarized. The value of UGWL for surgeons in treating NPBL through surgical resection results, ultrasound review and communication with surgeons were evaluated. Results A total of 985 patients, 1166 nonpalpable breast lesions were guided by ultrasoundguided wire before operation. The patients ranged in age from 16 to 77 years, with a median age of 45 years. There are 11 ultrasound doctors involved in wire positioning, and have worked in interventional ultrasound for 1 to 20 years. A total of 1166 lesions were removed. After operation review, no cases were missed. The median diameter of all lesions was 10 (2, 41) mm, and the largest diameter of lesions ≤20 mm accounted for 9537%. The median maximum diameter of malignant lesions was 10 (4, 36) mm, the median maximum diameter of benign lesions was 9 (2, 41) mm, and the median maximum diameter of benign and malignant lesions was statistically different (P＜0.05). The distribution of lesions in different quadrants, the location distribution of benign and malignant lesions was not statistically different (P＞0.05). Postoperative pathological results showed 1064 lesions (91.25%) of benign lesions and 102 lesions (8.75%) of malignant lesions. Among the malignant lesions, there were 35 of carcinoma in situ, 66 of invasive carcinoma, and 1 of undifferentiated pleomorphic sarcoma. There were 0 hematoma, infection, pneumothorax, and guidewire displacement caused by UGWL. Ultrasound images showed that the guide wire was positioned accurately but the clinical feedback was too shallow in 4 cases.Conclusion Ultrasoundguided wire localization not only solves the problem of the surgeon's precise removal of NPBL, but also satisfies the minimally invasive surgery to meet the aesthetic needs of modern women for breast shape, which is worth recommending.