Abstract: Breast cancer has become the most common malignant tumor globally. Currently, the treatment of breast cancer primarly adopts a comprehensive treatment plan based on surgery. Nipple-sparing mastectomy (NSM), as a surgical procedure for breast surgery, preserves all breast skin and the nipple-areolar complex (NAC). Postoperative breast reconstruction can obtain good aesthetic results and has significant advantages. While ensuring the safety of oncology, NSM improves the patient’s quality of life and has received increased attention in clinical practice. Thus, this article reviews the indications, contraindications, oncological safety, aesthetic effects, complications, and management of NSM after recurrence.