Background: Breast abscesses are common among lactating women, necessitating prompt treatment to alleviate symptoms and prevent complications. Traditional management involves conventional incision and drainage (CID), which is effective but associated with drawbacks. Ultrasound-guided needle aspiration/re-aspiration (UGNA) has emerged as a minimally invasive alternative. Methods: This randomized controlled trial enrolled 50 adult women with breast abscesses, randomized into CID (n=25) and UGNA (n=25) groups. Primary outcomes included time to resolution, pain scores, patient satisfaction, and complication rates. Results: In comparison to CID (14.2 ± 3.6 days), UGNA produced a resolution that was substantially faster (7.5 ± 2.3 days) (p < 0.001). Pain scores were consistently lower in the UGNA group at all assessed time points (p < 0.01). In the UGNA group, patient satisfaction was notably higher at 80% than in the CID group at 40% (p < 0.01). Additionally, UGNA resulted with fewer problems, such as no substantial scarring (0% vs. 16%) and a decreased recurrence rate (8% vs. 24%) (p < 0.05). Conclusion: UGNA should be prioritized as initial treatment for breast abscesses due to its efficacy, improved patient satisfaction, and decreased likelihood of complications. Adoption of UGNA in tertiary healthcare settings could enhance patient outcomes and management efficiency.