To investigate the diagnostic value of routine color doppler ultrasonography combined with micropure ultrasonography and super microvascular imaging (SMI) in breast masses. Methods 128 breast masses of 97 patients were served as research objects, and routine color doppler ultrasonography combined with micropure and SMI were performed. Pathological examination results are the gold standard, to analyze the calcification and blood flow distribution of benign and malignant breast masses, and the diagnostic efficiency of benign and malignant breast masses was evaluated among micropure, SIM and their combination. Results In a total of 128 breast masses, including 84 benign masses, the microcalcification detected by micropure ultrasonography was not significantly different from that detected by gray-scale ultrasonography (P＞0.05). In 44 malignant masses, micropure ultrasonography imaging identified 36 cases of microcalcification, with a detection rate of 81.82%, and gray-scale ultrasound identified 21 cases of microcalcification, with a detection rate of 47.73%. It was proved that micropure ultrasonography can identify more microcalcifications than gray-scale ultrasound in malignant masses; using the number of 3 microcalcifications as the cut-off point to compare the calcification distribution of benign and malignant masses in the 47 mseese with positive microcalcifications. It was found that benign masses were mainly scattered with less than 3 microcalcifications, and malignant masses were mainly composed of multiple microcalcifications greater than or equal to 3(P=0.03). The detection rate of SMI blood flow was 98.46%, the detection rate of CDFI was 75.38%, and the difference was statistically significant (P=0.00), which proves that SMI can detect more blood flow signals than CDFI; it was found that the SMI blood flow Adler grading in malignant masses was higher than that in benign masses, and the difference was statistically significant (P=0.00). Conventional breast color Doppler ultrasound combined with micropure ultrasonography and SMI can significantly improve the sensitivity, specificity and accuracy of diagnosing benign and malignant breast masses, and it is significantly better than the simple combination of micropure ultrasonography or simple combination of SMI, and the difference is statistically significant (P＜0.05). Conclusion Micropure ultrasonography, SMI and CDFI have their own advantages. Combined application can significantly improve the differential diagnosis of benign and malignant breast masses