The evaluation of the sentinel lymph node (SLN) is important for the treatment plan and prognosis of breast cancer patients. Conventional ultrasound can only evaluate axillary lymph node based on the morphological structure, echo and blood flow distribution of lymph node, while contrast-enhanced ultrasound (CEUS) can overcome the limitation of low diagnostic performance from traditional ultrasound, and provide a new idea for the successful localization and characterization of SLN. Currently, CEUS has been gradually applied in clinical. CEUS can accurately locate SLN and help clinicians exactly find SLN during surgery. CEUS can also estimate the benign or malignant according to the blood perfusion information of SLN, which is conducive to developing personalized treatment plan, improving prognosis and reducing overtreatment of patients. In addition, CEUS guidance of SLN biopsy will significantly improve the detection rate of metastatic SLN. It is worth noting that, with the continuous development of clinical studies, CEUS has been proved to be able to trace multiple lymphatic drainage channels of SLN, clearly show the spatial anatomical relationship between lymphatic drainage channels and SLN, and reduce the false negative diagnosis of SLN.