AbstractDuring a 6-year period 38 patients with 52 mammillary fistulae were seen. On average, 5 abscesses had preceded recognition of a fistula in the areolar region (range 1–18). In 11 cases the fistulae were immediately apparent as discharging openings but they more commonly presented as subareolar abscesses. Fistulae were treated either by laying open or by excision of the track and at mean follow-up of 25 months (range 1–75) there has been recurrent fistula formation in only one case. Mammillary fistulae should be suspected and sought in all patients presenting with abscesses adjacent to the nipple.