INTRODUCTIONAccessory breasts can develop in the mammary or milk line. The accessory breast incidence is stated to be 0.4%-0.6% in women.1 This ectopic breast tissue is commonly present in the axilla. The axillary ectopic breast is quite common in women in Asia. The exact incidence is not available in India. The clinical presentation of accessory breast may be asymptomatic or may present with pain in the premenstrual phase due to congestion. Many women are anxious about presence of swelling in the axilla. The breast cancer awareness programs also bring these women to clinician for lump in the axilla. Most of women present for the cosmetic problem. The Indian women wear ethnic dress which covers the axilla, so women are less anxious about this cosmetic deformity. As more women are resorting to sleeveless dress the axillary swelling is a cosmetic problem for them. These accessory breast may be present in either or both the axilla. Occasionally the aberrant breast tissue is seen in axilla, scapula, thigh and labia majora. Axillary accessory breast can present as palpable thickening in the axilla to a pendulous mass. These axillary breasts can become tender and increase in size during premenstrual period. For these symptoms more women are seeking surgeon consultation. These women want investigations to rule out breast carcinoma.3 Reassurance or counseling that the axillary swelling is accessory breast tissue which has enlarged during lactation works only when breast ABSTRACT Background: The axillary accessory breast tissue develops as part of polymastia along the milk line. This is of common occurrence in women. The clinical presentation can be from asymptomatic to cyclical changes. Enlargement of axillary accessory breast tissue is during pregnancy and lactation. The most common reason for seeking surgical consultation is anxiety for development of carcinoma. Small number of women opted for surgery purely for cosmetic reason. Methods: A total of 60 women were included in the study. The age of these women was between 19 to 50 years. Fifty women opted for surgical excision. Results:The most common symptom in these patients was exacerbation during pregnancy and lactation in 30 patients. This enlargement was the also the most common cause anxiety by patients for development of carcinoma. The palpable thickening in 10 patients was another cause of anxiety. Only 6 patients had large pendulous mass and had already made up their mind for removal of this mass. The clinical presentation in rest of the patients represented comparatively small number of patients. Conclusions: The potential of malignancy in accessory axillary breast is more than normal breast, it is essential to investigate these patients. The surgical excision of these accessory breasts is quite safe and is recommended for all the patients having symptoms.