OBJECTIVE: The aim of this study is to investigate the correlation between breast vascularity level and Tanner staging in the evaluation of thelarche, and to compare Doppler methods for demonstrating vascularity.MATERIAL AND METHODS: Girls aged 6–10 who were referred to the radiology clinic with a complaint of breast swelling and prediagnosed with precocious puberty between October and December 2017 were included in the study. Breast ultrasonography (US) and color doppler ultrasonography (CDUS) examinations were performed on all participants. Age, Follicle Stimulating Hormone (FSH), Luteinizing Hormone (LH), Estradiol (E2), thelarche stage, both breast volumes were recorded for all participants. Vascular scores were measured for both breasts using imaging modalities such as color doppler (CD), Power US (PD), and superb microvascular imaging (SMI).RESULTS: We included 116 girls and 213 thelarche breasts in the study. A significant correlation was found between the depth and transverse and longitudinal diameter for each breast and breast volume and Tanner stages (rs = 0.762, rs = 0.830, rs = 0.774 rs = 0.824, respectively; p < 0.001). Although the highest correlation between Doppler methods was found in PD (PD rs =0.68, CD rs =: 0.61, SMI rs =:0.61, p<0.001), the methods did not have any superiority over each other (p>0.05). Vascularization with SMI was demonstrated in 30 of 65 breasts for which vascularization could not be demonstrated with power Doppler. Among these 30 cases, 90% (n = 27) were Tanner stage I and II.CONCLUSIONS: In conclusion, although SMI is as successful as conventional Doppler methods in the evaluation of thelarche vascularity, it can provide more data in some cases.