OBJECTIVE: The purpose of this study was to analyze the accuracy and clinical value of digital breast tomosynthesis (DBT) in patients with nipple discharge and to compare it with other radiological methods (mammography, ultrasound (US) and magnetic resonance imaging (MR)) used in the treatment of nipple discharge. ----- METHODS AND MATERIALS: This retrospective study included 53 patients with nipple discharge with an average age of 54 years. All patients underwent DBT and the results were compared to mammography, ultrasound and MR. The findings of mammography, DBT, ultrasound and MR were categorized according to the BI-RADS classification, where categories 1-2 were considered negative and 3-5 positive. The final diagnosis for patients with a suspicious radiological finding was made on the basis of the pathohistological (PHD) results of the tissue sample, while confirmation of the benign radiological finding required unchanged results in the two-year follow-up. The diagnostic accuracy of mammography, DTD, ultrasound, and MR for the detection of breast cancer were calculated. ----- RESULTS: Out of 53 patients with nipple discharge, the final PHD analysis showed 6 (11.3%) malignant lesions. All malignant lesions were detected in patients with pathological discharge. DBT and MR showed high sensitivity (100%) and negative predictive value (100%) in the detection of breast cancer in patients with nipple discharge. DBT showed greater specificity compared to MR (82.9% vs. 61.9%). Mammography had a sensitivity of 83.3% and a specificity of 76.6% in detecting breast cancer. The sensitivity and specificity of ultrasound in the detection of breast cancer were 66.7% and 57.5%, respectively. ----- CONCLUSION: DTD has higher specificity, and the same sensitivity and negative predictive value as MR. For this reason, the use of DBT as an alternative method to MR in the assessment of patients with nipple discharge should be considered.