The aim of this study was to evaluate the role of mammography and the outpatient follow up in the management of breast cysts. Prospective data was collected in 203 women from July 2000 to July 2005. All women had an ultrasound scan and aspiration. One hundred and seventy-six women above 35 years had a mammogram. All women were followed up 4-6 weeks later. Women with M3 or M4 mammography or with suspicious ultrasound findings on initial clinical visit were investigated further; 96.53% presented with a lump in the breast. Aspiration was performed in all women. Three patients had a residual lump on 4-6 week follow up. One was found to be benign and two were revealed to have cancer. The mammogram findings in these two patients were M3 and they would have merited further investigation anyway. In total 176 patients had a mammogram and a departmental ultrasound scan of the breasts of which 41 patients required further investigations following which cancer was found in nine patients (4.4%). Mammography is an important tool in the management of breast cysts. Outpatient follow up did not contribute significantly to the care of these patients.