Objective To explore the value of automated breast volume scanner (ABVS) combined with contrast-enhanced ultrasound (CEUS) in the differential diagnosis of benign and malignant breast intraductal lesions. Methods A total of 110 patients with breast intraductal diseases who received surgical treatment in our hospital from Aug. 2021 to Mar. 2023 were enrolled. According to the postoperative pathological results, they were divided into malignant lesion group (60 cases) and benign lesion group (50 cases). ABVS and CEUS were performed in both groups before surgery. The differential diagnostic efficacies of the 2 methods alone and in combination for benign and malignant breast intraductal lesions were analyzed. Results The sensitivities, specificities, and accuracies in diagnosing benign and malignant breast intraductal lesions were 80.00%, 90.00%, and 84.55% by CEUS alone, and 83.33%, 88.00%, and 85.45% by ABVS alone, respectively. The sensitivity (95.00%) and accuracy (90.00%) of the combined examination were significantly higher than those of the single examination. Conclusion ABVS combined with CEUS can improve the differential diagnostic efficacy of benign and malignant breast intraductal lesions with high sensitivity and accuracy.