OBJECTIVE: To review the role of ultrasound-guided core-needle biopsy (CNB) in the management of breast lesions. METHODS: Review of the most relevant literature on this topic. RESULTS: This technique shows a high sensitivity value of about 97.5% and it offers many advantages over other imaging techniques to guide a biopsy: non-ionising radiation, low cost, full control of the needle in real time, accessibility in difficult locations, multidirectional punctures and excellent comfort for patients and radiologists. All of these advantages have made this technique the most widespread used to perform a biopsy for a suspicious breast lesion. The most important limitation is the failure to perform a biopsy for lesions that are not seen on ultrasound. An adequate radiological-pathological correlation is necessary to minimise the false-negative results. CONCLUSION: Ultrasound-guided CNB has proven to be a reliable technique for performing a biopsy for breast lesions that can be clearly seen on ultrasound.