Abstract: Objective:To compare the therapeutic effects between immediate breast reconstruction (IBR) after skin-sparing mastecto -my and modified radical mastectomy (MRM) in young breast cancer patients (≤ 35years), as well as to analyze the prognostic factors of IBR in these patients. Methods:The clinicopathological data of young breast cancer patients who had undergone IBR after skin-spar-ing mastectomy (60cases) and MRM ( 68cases) in Liuzhou People's Hospital from July 2008to June 2014were retrospectively ana-lyzed. Local recurrence, disease-free survival, and overall survival of the patients between the two groups were compared. The influ -encing factors for survival of the IBR group patients, such as age, tumor size, and nipple-areolar complex preservation, were analyzed. Results: All patients were followed-up for a period ranging from 15to 88months with a median of51. In the IBR group, local recur-rence, distant metastasis, and death occurred in 3, 8, and 5 cases, respectively. The 3- and 5- year disease- free survival rates (DFSR) were 91. 7% and 81. 7%, respectively, whereas the overall survival rate (OSR) was 91. 7%. In the MRM group, local recurrence, distant metastasis, and death occurred in 2, 9, and 5 cases, respectively. The 3- and 5-year DFSRs were 94. 1% and 83. 8%, respectively, where-as the OSR was92. 6%. No statistical difference was noted between the two groups (P>0. 05). The analysis of prognostic correlation fac -tors in the IBR group patients shows that lymph node metastasis and estrogen and progesterone receptor-negative correlated with the tumor-free survival and overall survival rates ( P<0. 05). Conclusion: No apparent statistical difference in the comparison of the local re-currence and long- term survival rate was observed between the two groups' young breast cancer patients who underwent IBR after skin-sparing mastectomy and MRM. IBR after skin-sparing mastectomy is safe for young breast cancer patients with early-stage, and nipple-areolar complex preservation does not increase the risk of recurrence in the IBR group patients. Lymph node metastasis and es-trogen and progesterone receptor-negative are the major prognostic factors of IBR after skin-sparing mastectomy in young breast can -cer patients.