Abstract: Objective To analyze the characteristic MRI manifestations of young breast cancer patients with different molecular types. Methods A total of 406 patients with pathologically confirmed breast cancer who were admitted to the Affiliated Cancer Hospital of Xinjiang Medical University from April 2013 to December 2020 were selected, including 190 breast cancer patients in a young group (<40 years old) and 216 breast cancer patients in a middle-aged and elderly group (≥40 years old). All the patients underwent MRI examination before surgery. Both groups were compared for characteristic MRI manifestations. Young breast cancer patients with different molecular types were compared for MRI characteristics and histological stages. Results Compared with breast cancer patients in the middle-aged and elderly group, those in the young group were more likely to present clear margins and uneven enhancement, with increases in initial enhancement rate (IER) and decreases in apparent diffusion coefficient (ADC) values (both P<0.05). In the young group, the triple-negative type breast cancer showed significantly higher IER than the Luminal A type (P<0.05); the Luminal B type breast cancer presented higher ADC value than the HER-2 overexpression type and the triple-negative type (P<0.05); and the HER-2 overexpression type and the triple-negative type breast cancer were mainly histological stage Ⅲ, while the Luminal A type and the Luminal B type was predominantly stage Ⅱ(P<0.05). Conclusions The MRI manifestations of young breast cancer have certain characteristics, which can provide reference for the formulation of clinical treatment regimen and prognosis assessment.