ABSTRACT Background: Although CBS was found to be nearly equal to radical approaches as it allow removal of diseased tissues with sufficient safety margins of un-diseased breast tissues but the shape of the breast is not conserved that lead to marked post-operative deformities which leads to psychic troubles particularly in younger females. Oncoplastic breast surgery (OBS) allows better resection of huge tumors and it becomes a preferred surgical approach of cancer breast management as it allows combination of both oncological and plastic surgery principles and reaching satisfaction in both oncological and aesthetic results. Aim of the current study is to compare between CBS and OBS as two different techniques of primary breast cancer management in female patients regarding surgical outcome and postoperative findings. Methods: The current study is a comparative, prospective and randomized analysis included 120 breast cancer patients who were divided into two groups: group 1 which included 45 patients who underwent OBS; and group 2 which included 75 patients who underwent CBS. Results: We showed that patients underwent OBS were younger than CBS group (P=0.009). OBS was more frequently performed for tumors in the lower quadrants (p=0.001). Surgical safety margins and volume of excised tissues were larger in OBS group than in CBS group (p=0.001). Patients’ satisfaction was higher in OBS group than in CBS group (p<0.001). We found a lower rate for re-excision and completion mastectomy in OBS group than in CBS group (p=0.002). Conclusions: We have confirmed safety and feasibility of OBS, reducing rate of post-operative positive margins, tumor recurrence, produced a better cosmetic appearance and a higher patient’s satisfaction than the conventional methods of CBS.