Cholesterol granuloma is a rare non-infectious disease. Currently, there are no established guidelines, leaving the clinician to decide the best practice for each patient. A 43-year-old woman presented to the Surgery Clinic at Siloam General Hospital, Tangerang, Banten, Indonesia, with the primary complaint of a painful mass located in her left breast over the previous week before being admitted to the hospital. The mass was found abruptly and was accompanied by severe pain and fever. On

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... ion, peau d'orange, nipple retraction, tenderness, and warmth of the skin were observed. Ultrasonography suggested a malignant mass. The primary diagnosis was breast cancer, with a secondary differential diagnosis of breast abscess. An open biopsy was chosen because a breast abscess was the possible diagnosis. The biopsy results showed characteristics of cholesterol granuloma. Following the operation, the pain score was notably reduced as the operation showed a satisfactory result. The primary purpose of this case report was to illustrate a case of breast abscess caused by cholesterol granuloma, in which open excisional biopsy and drainage was superior for pain reduction and faster recovery.