Purpose This prospective observational study was undertaken to evaluate the correlation of the axillary Ultrasound findings, Tru-Cut/fine-needle aspiration cytology (FNAC) results and final histology reports for axillary lymph nodes involvement in patients diagnosed with breast cancer. Methods and materials In this observational study, 141 consecutive breast cancer patients are included from 01/10/2013 to 30/10/2014. Cortical thickness of Results This study revealed 57.14% sensitivity and 93.39% specificity of axillary ultrasound, which are comparable to the published data (35%–82% and 73%–98% respectively). We missed three patients with breast cancer who had heavily involved axillary lymph nodes, on axillary ultrasound. This was proven on axillary surgery. Conclusion The standards of axillary ultrasound services at our unit, in detecting metastatic lymph node involvement in breast cancer patients, are comparable to the published accuracy rate in preoperative diagnosis of axillary lymph node metastasis.