Background: Breast reduction for macromastia represents one of the common aesthetic surgeries. The currently available methods include surgical reduction and/or liposuction. The most commonly performed surgical technique is the inferior pedicle.Aim: This prospective study aimed to compare the results of surgical reduction by inferior pedicle versus liposuction alone.Patients and Methods: Between January 2015 and November 2017 fifty two patients were undergone breast reduction by either liposuction alone in 26 patients (group A), Or inferior pedicle technique in the other 26 patients (group B). The patient's demographics, operative notes, hospital stays, reduction in size and volume, postoperative complications and patient's satisfaction were recorded and statistically analyzed.Results: The operative time, hospital stay, the postoperative complication rate was significantly lower in group A, while the reduction in size and volume was significantly higher in group B. Patient's satisfaction noted to be higher in group A. Significant high rates of complications were observed in inferior pedicle reduction. Regarding patient's satisfaction based on our finding that instead of liposuction reduction alone did not achieve a great reduction in size but patients in this group presenting higher satisfaction rate than the inferior pedicle group due to absence of visible scar.Conclusion: Based on the finding in this study liposuction breast reduction alone is recommended as first option for breast reduction of medium and even large sized breasts with good skin quality especially for unmarried young females. The inferior pedicle technique might be chosen for reduction of giant breasts.