Objective: To investigate the clinical efficacy and application value of neoadjuvant chemotherapy plus breast-conserving surgery for middle-advanced stage breast cancer. Methods: The clinical data of 97 patients with stage II-III breast cancer treated from February 2008 to February 2010 were retrospectively analyzed. Of the patients, 41 cases received neoadjuvant chemotherapy plus breast-conserving surgery (breast-conserving group, patients undergoing neoadjuvant chemotherapy before surgery) and 56 cases were subjected to modified radical mastectomy (modified radical surgery group, patients undergoing no chemotherapy before surgery). The clinical efficacies between the two groups were compared. Results: The objective response rate in breast-conserving group was significantly higher than that in modified radical surgery group (73.17% vs. 57.14%, P<0.05). After the follow-up period of a median of 23.2 months, patients in breast-conserving surgery group all survived, with one case of local recurrence and no distant metastasis; in modified radical surgery group, local recurrence occurred in 6 cases and distant metastasis occurred in 5 cases, 3 cases of whom died. The median progression-free survival in breast-conserving group and modified radical surgery group was 32.3 and 22.1 months, respectively (P<0.05). In breast-conserving surgery group, cosmetic evaluation of breast appearance for 82.93% cases was excellent, subjective cosmetic satisfaction in 90.24% cases was very satisfied and in 7.32% cases was satisfied. Conclusion: Neoadjuvant chemotherapy can remarkably decrease the clinical stage of middle-advanced stage breast cancer before breast-conserving surgery, and the short-term postoperative efficacy and cosmetic results are all satisfactory, with important clinical benefits for some of these patents.