Although the parallel artery and vein sign is an uncommon finding, it has a significant association with benign pathologic results (96.5%) with a positive likelihood ratio of 24.7. The presence of this color Doppler ultrasound finding in breast masses in BI-RADS ultrasound categories 3 and 4 reinforces the benign nature and may allow follow-up rather than biopsy in the care of some patients.