Objective: To investigate the value of using pectoralis major fascia in the immediate breast reconstruction following mastectomy for breast cancer. Methods: The clinical data of 18 patients with early breast cancer undergoing subcutaneous mastectomy with nipple-areola complex preservation and immediate breast reconstruction between May 2014 and September 2016 were retrospectively analyzed. All patients received breast reconstruction with prosthesis covered and wrapped by the pectoralis major muscle and its fascia, namely, firstly, the pectoralis major fascia was detached from the pectoralis major muscle, with a direction from the parasternal and infraclavicular region toward the lateral region, and then the prosthesis was implanted between the pectoralis major and minor muscles, and finally, the lateral border of the pectoralis major muscle was sutured to the detached pectoralis major fascia for firmly wrapping the prosthesis. Results: Breast reconstruction was successfully performed in all the 18 patients. During the follow-up period of 12 to 40 months, no recurrence or metastasis occurred in any of the patients, all reconstructed breasts displayed a natural shape and acceptable symmetry, no displacement or contracture of the breast prosthesis was noted, and the postoperative appearance good rate was 100%. Conclusion: For some early breast cancer patients, subcutaneous mastectomy with nipple-areola complex preservation plus immediate breast reconstruction using pectoralis major muscle and its fascia covering and wrapping the prosthesis is simple and easy to perform, with excellent cosmetic effect and few complications.