Breast reconstruction is an important component of breast cancer treatment, in which the breast reconstruction using free perforator flaps requires skilled surgical technique in microvascular anastomosis. At present, the microvascular anastomosis training program includes a variety of skill training methods and assessment systems. Here, the authors, based on relevant literature, review and discuss the practicability of various methods and the objectiveness of the assessments, to provide learning and practicing suggestions for breast surgeons.