Objective To investigate the correlations between the expression of vascular endothelial growth factor (VEGF) and thrombospondin 1 (TSP-1) in breast cancer and the prognosis. Methods Immunohistochemical staining was used to detect the expression of VEGF and TSP-1 in 160 cases of breast cancer tissues and adjacent tissues, and the relationships between them were analyzed. Results The expression of TSP-1 significantly decreased and the expression of VEGF significantly increased in breast cancer tissues. Low expression of TSP-1 and high expression of VEGF were significantly associated with high clinical stage, poor differentiation, and lymph node metastasis. After 3 years of follow-up, the recurrence rate was 15.6%. Spearman rank correlation analysis showed that there was a positive correlation between the prognosis recurrence rate and the positive expression rate of VEGF (r=0.459), but negatively correlated with the positive expression rate of TSP-1 (r=-0.543). Logistic regression analysis showed that TSP-1 positive expression rate, VEGF positive expression rate, lymph node metastasis and clinical stage were the main independent risk factors for prognosis and recurrence. Conclusion The high expression of VEGF and the low expression of TSP-1 in breast cancer tissues are significantly correlated with the main clinical features. The recurrence rate of patients with high expression of VEGF and low expression of TSP is high.