Objective: To investigate the risk factors for non-sentinel lymph node (NSLN) metastasis in breast cancer patients with positive sentinel lymph node biopsy (SLNB) results. Methods: The clinical data of 138 breast cancer patients with positive SLNB results admitted from July 2009 to October 2013 at the affiliated tumor hospital of Xinjiang Medical University were collected. The relations of the clinicopathologic factors with NSLN metastasis were determined by univariate and multivariate Logistic regression analysis. Results: Univariate analysis showed that primary tumor diameter, histological grade, rate of sentinel lymph node metastases, maximal diameter of the sentinel lymph node metastases and vessel invasion were related to NSLN metastasis (all P<0.05); Logistic regression analysis identified that primary tumor diameter (OR=2.263, P=0.005), rate of sentinel lymph node metastases (OR=1.919, P=0.002), maximal diameter of the sentinel lymph node metastases (OR=8.479, P=0.000) and vessel invasion (OR=4.518, P=0.029) were independent risk factors for NSLN metastasis. Conclusion: Primary tumor diameter, rate of sentinel lymph node metastases, maximal diameter of the sentinel lymph node metastases, and vessel invasion can be used as independent variables to predict NSLN metastasis in breast cancer patients.