Background: Oncoplastic techniques in breast cancer therapy allows for extending the indications of breastconservative surgery plus improving cosmetic outcomes. Breast tumors located at the upper inner quadrant particularly represent a challenge for conservative surgery due to the scarcity of breast tissue and the risk of skin involvement. Aim of Study:This study aims to compare the outcomes of inferior pedicle mammoplasty and matrix rotation flap in medium-sized to large-breasted females with breast cancer located in the upper inner quadrant.Patients and Methods: From August 2013 to August 2021, 27 females patients with medium-sized to large-sized breasts diagnosed with early upper inner quadrant breast cancer and suitable for breast conservation underwent therapeutic mammoplasty depending on either inferior pedicle technique (group I) or matrix rotation mammoplasty technique (group II). Patients with multicentric breast cancer and those with persistent involved resection margins after excision were excluded from the study. Surgical outcomes, oncologic safety, and cosmetic results were assessed and compared between both groups.Results: There is significant difference between the two groups as regards the operative time, intraoperative blood loss, hospital stay, postoperative complications, cosmetic outcome and the need for contralateral symmetrization. Inferior pedicle mammaplasty needs longer operative time and postoperative hospital stay with more intraoperative blood loss in comparison to matrix rotation mammoplasty. As regards the postoperative complications, we found that there are more complications in inferior pedicle mammaplasty than matrix rotation mammoplastyas wound infection and nipple areola ischemia. Conclusion:Patients with early breast cancer located in the upper inner quadrant are candidate for either inferior pedicle mammoplasty or matrix rotation mammoplasty. Matrix rotation mammoplasty is better in some concerns as there is less morbidity, no need for contralateral symmetrization and fewer complications, so no delay in radiotherapy.