ABSTRACT Incidentalomas are lesions incidentally identified in patients undergoing imaging for unrelated reasons. Breast incidentalomas have a high correlation with malignancy, occurring in over 40% of cases. Consequently, their interpretation poses significant challenges for radiologists who must discern the findings that may present a potential risk to the patient. This pictorial review presents different incidental breast lesions revealed through cross-sectional imaging. We further review key concepts related to such incidentalomas.