Aims: We aimed to evaluate the effect of primary tumour resection in stage IV breast cancer on survival. Study Design: Retrospective data analysis. Place and Duration of Study: Hacettepe University Faculty of Medicine Departments of General Surgery and Medical Oncology between 2001 and 2008. Methodology: A total of 118 patients with breast cancer in whom metastasis was found at the time of diagnosis or within two months of operation were included in the present study and analysed retrospectively. Seventy-six patients (63.4%) underwent surgical treatment, while 42 (36.6%) underwent only diagnostic biopsy and were administered medical treatment. Results: The mean follow-up was 28 months. The median overal survival was 44 months in operation group and 34 months in non-operation group. The oestrogen and progesterone receptor status, and type of metastasis had a significant effect on survival. The median two-year survival was higher in operation group (23 months vs. 18 months, p=0.013). The survival was significantly higher in patients with only bone metastasis than those with other types of metastasis (p<0.001). Among patients with only bone metastasis, there was no survival difference between operation and non-operation groups (p=0.201). The median survival was significantly longer in operation group than non-operation group in patients with only visceral metastasis (p=0.006). Conclusion: The surgical treatment has favorable effect on survival in stage IV breast cancer, thus should be combined with systemic treatment to increase success rates.