Purpose Idiopathic granulomatous mastitis (IGM) is a rare benign inflammatory breast disease of unknown cause. It can be unilateral/bilateral and often occurs within 5 years of pregnancy. There may be an association between IGM and Corynebacterium Kroppenstedtii species and subtypes as well as increased Prolactin levels. This rare and ambiguous condition can be a treatment dilemma for patients and clinicians and often has to burn out over 5-20 months. Methodology: We present the case of 48-year-old women with recurrent IGM in bilateral breasts requiring multiple surgical debridements and antibiotic therapy. She had grown Corynebacterium species prior and was on Augmentin and Doxycycline. We conducted a thorough review of the English literature on Medline and UptoDate using the keywords “IGM” and “treatment” to review potential treatment options. Results: Often no specific management is necessary with IGM being a self-limiting inflammatory condition. Surgical excision is often associated with slow wound healing and should be avoided unless there is more severe infection/abscess formation. 5-7 days of Doxycycline 100mg BD for Corynebacterium is suggested. The role for steroids (Prednisone) and Methotrexate in refractory disease is controversial and the decision to treat is often based on the size and severity of the lesion. Conclusions: IGM is a difficult, rare condition with complex aetiology. Patients are treated conservatively with targeted antibiotics and pain relief. Surgical debridement and adjuvant treatments is reserved for severe refractory disease and should be done in consultation with a breast surgeon. IGM typically self resolves over time.