Background and Aims Oncoplastic breast-conserving surgery (OBCS) allows complete excision of tumors while maximally maintaining the natural breast contours, thereby improving the patients' quality of life. However, OBCS is a newly emerging technique, the clinical evidence of its efficacy and safety is still limited. Therefore, this study was conducted to further determine the clinical efficacy and safety of OBCS through comparing the relevant clinical variables between OBCS and traditional breast-conserving surgery (TBCS) in the treratment of early breast cancer.Methods The clinical data and follow-up records of 226 patients who underwent breast-conserving surgery for breast cancer in the Department of Oncology Surgery of Xinxiang Central Hospital from January 2015 to January 2020 were retrospectively analyzed. Of the patients, 95 cases underwent OBCS (OBCS group) and 131 cases were subjected to TBCS (TBCS group). The clinical variables that included the operation-related indexes, incidence of postoperative complications, postoperative cosmetic outcomes, patients' subjective satisfaction and long-term efficacy between the two groups of patients were compared and evaluated.Results In OBCS group, the defect closure methods included glandular advancement in 47 cases, transposition flap placement in 22 cases, inverted-T mammoplasty in 5 cases, bat-wing technique in 9 cases, pedicled omental flap reconstruction in 3 cases, partial latissimus dorsi added fat flap reconstruction in 3 cases, latissimus dorsi flap reconstruction in 4 cases, and rectus abdominis flap transposition in 2 cases. In TBCS group, the extended local excision of the tumor was performed in all patients, followed by direct residual gland suture. The operative time in OBCS group was significantly longer than that in OBCS group [(136.8±28.5) min vs. (75.2±22.3) min, P=0.002], but the rate of intraoperative second extended resection for positive margin in OBCS group was significantly lower than that in TBCS group (3.2% vs.11.5%, P=0.027). The volume of resected specimen in OBCS group was significantly larger than that in TBCS group [(101.3±12.9) mL vs. (67.6±9.8) mL, P=0.013]. The excellent and good rate of breast cosmetic effect in OBCS group was significantly higher than that in TBCS group (86.3% vs. 37.4%, P=0.000). The subjective satisfaction rate in OBCS group was significantly higher than that in TBCS group (91.6% vs. 44.3%, P=0.000). There were no significant differences in intraoperative blood loss, axillary lymph node dissection, incidence of postoperative complications, total length of hospital stay, postoperative local recurrence rate, disease-free survival rate and overall survival rate between the two groups (all P>0.05).Conclusion The application of oncoplastic surgery in breast-conserving surgery for appropriate breast cancer patients can offer better cosmetic effect and better subjective satisfaction, improve the patients’ quality of life without increase of the risk of complications as well as tumor recurrence and metastasis. So, it is recommended to be used in clinical parctice.