Objective: To investigate the clinicopathological characteristics of granulomatous lobular mastitis (GLM). Methods: The archives of 31 cases of GLM diagnosed by pathology from January 2015 to November 2018 in Wuhan Pulmonary Hospital were collected and the clinical, imaging, laboratory and pathological features were analyzed. Results: All the 31 patients were female, aged 18–48 years, with a median age of 31 years. Twenty-nine patients had a history of reproduction and lactation. The lesion location:15 cases in left breast and 16 case in right breast. All cases presented with unilateral breast mass clinically and may accompany by pain, skin swelling, ulceration, axillary lymph node enlargement and nipple depression. Fine needle aspiration cytology of 30 cases proposed suspicious breast tuberculosis. Hypoechoic heterogeneous masses were detected by breast gland ultrasound mainly. On MRI the masses were irregular with high signal on T1WI and high or slightly high signal on T2WI. All cases were confirmed by pathology after operation. No Mycobacterium tuberculosis was detected in surgical specimens, and only one case was detected Mycobacterium tortoise subspecies. Grossly, the mass had no envelope, with grey-white , grey-yellow section and tough texture and small pus cavity and yellow-white miliary lesions. Microscopically, it was characterized by multiple foci of suppurative granuloma centered on the terminal lobular duct of the breast without caseous necrosis, often with lipid absorption vacuoles and microabscesses, and lobular structure could be destroyed. Conclusion: GLM is a rare chronic inflammatory disease of the breast and has certain clinical, imaging and pathological characteristics. Clinicians and pathologists should pay attention to it to reduce misdiagnosis and mistreatment.