Introduction: Arteriovenous Malformations (AVM) are abnormal vascular connections between the arterial and venous system bypassing the capillaries. AVMs can affect any organ but are extremely rare in the breast. A 2021 review identified nine cases, with seven more reported in 2024. We present our rare experience. Case Report: A 45-year-old women presented with a left breast lump and mastalgia, but no nipple discharge or skin changes. There was no immediate family history of breast cancer. Examination revealed no visible changes, palpable lumps or lymphadenopathy. USS showed prominent vessels with no mass. Contrast-enhanced MRI identified a 9mm micro-lobulated lesion with low T1 and high T2 signals, homogeneous contrast enhancement, and a prominent adjacent artery. After multidisciplinary discussion, core biopsy was avoided due to bleeding risk, so an excisional biopsy with pre-operative ultrasound marking was performed. However, intra-operative doppler flow was lost, and histopathology showed no vascular lesion. A six-month follow-up ultrasound showed a stable vascular lesion, and surveillance was recommended. Discussion: Breast AVMs can be congenital or acquired. Symptoms may include palpable mass, mastalgia, skin changes, or may be asymptomatic. Diagnostic tests include duplex USS, CT angiography or contrast-enhanced MRI. Diagnosis is difficult because biopsy is avoided due to bleeding risk. Management options include sclerotherapy, ablation, surgery or observation, with multidisciplinary input essential due to limited literature on management. Conclusion: Breast AVMs are rare and require a personalised approach for diagnosis and management. Further research is needed to improve understanding and standardise care.