BACKGROUND The clinical manifestations, imaging and pathological findings though typical are closely mimicking other specific granulomatous types like tuberculosis; mycotic the treatment for this condition needs to be carefully planned in the initial stage itself. This will resolve the psychological issues and prevent recurrence. The study includes 30 cases of granulomatous mastitis belonging to varying age groups, social status, parity and menopausal status. The diagnostic workup is mainly in the form of imaging and histopathological in close correlation with clinical findings, helped us to treat the patients effectively. The treatment modalities offered, results and followup are tabulated. The purpose of this study is to present the author's experience by their critical clinical analysis based on aetiopathological and imaging modalities and to formulate effective treatment modalities in granulomatous mastitis. MATERIALS AND METHODS The study was conducted in Vinayaka Mission's Medical College, Karaikal and Private Clinic in Thanjavur; 30 patients diagnosed as granulomatous mastitis were divided into 4 groups based on the treatment modalities offered to them; conservative antimicrobial therapy for 3 cases. Surgical drainage and/or surgical wide local excision in 27 cases. RESULTS Antimicrobial therapy after culture and sensitivity was given for 3 cases, out of which 1 case had improvement and drainage procedure was carried out in another case followed by excision for antibioma and the other case was lost to followup. Wide local excision was carried out in 27 patients, out of which 24 were cured, 2 patients had delayed healing and 1 patient was lost during followup. CONCLUSION Granulomatous mastitis is an inflammatory breast disease found in young women who present with a large painful irregular mass, which mimics carcinoma as a physical change. The correct diagnosis is established by cytological or histological examination. Granulomatous mastitis is a benign problem, but if not treated effectively and adequately life would be miserable with a chronic non-healing and multiple sinuses.