Objective To investigate the blood flow characteristics of breast cancer patients with different Traditional Chinese Medicine (TCM) syndromes by superb microvascular imaging (SMI). Methods A total of 62 patients with mass breast cancer (malignant group) and 50 patients with benign breast tumors (benign group), who were diagnosed by pathology in The First Affiliated Hospital of Heilongjiang University of Traditional Chinese Medicine from Jun. 2017 to Aug. 2021, were selected. The 62 breast cancer patients were divided into liver stagnation and phlegm coagulation syndrome group (24 cases), Chong Ren disorder syndrome group (20 cases) and positive deficiency and strong toxin syndrome group (18 cases). Before operation, all groups were given routine ultrasound and SMI, and the 2-dimensional ultrasound and ultra-fine blood flow characteristics were analyzed and compared among the groups. Results The 2-dimensional ultrasound showed significant differences in nodule size, microcalcification, posterior echo and lymph node metastasis among the benign group and 3 malignant syndrome groups (all P<0.01). There was significant difference in the number of SMI blood vessels between the benign group and 3 malignant syndrome groups (all P<0.05). The proportion of patients with SMI grade 0 in the liver stagnation and phlegm coagulation syndrome group was higher than those in the other 2 syndrome groups (both P<0.05). The proportion of patients with SMI grade Ⅲ in the positive deficiency and strong toxin syndrome group was higher than those in the other 2 syndrome groups, and the proportion of patients with grade I was lower than those in the other 2 syndrome groups (all P<0.05). The histopathological classification showed that the proportions of grade I patients in the liver stagnation and phlegm coagulation syndrome group, grade Ⅱ patients in the Chong Ren disorder syndrome group and grade Ⅲ patients in the positive deficiency and strong toxin syndrome group were all higher. Conclusion SMI can effectively reveal the characteristics of ultramicrovessels of breast cancer patients with different TCM syndromes, providing reliable basis for TCM syndrome differentiation treatment.