Objective　To investigate the clinical efficacy of neoadjuvant chemotherapy combined with breast-conserving surgery for locally advanced breast cancer. Methods　Eighty-one patients with locally advanced breast cancer were selected from those who were admitted into 309 Hospital of PLA from January 2009 to October 2013, consisting of 65 patients in stage Ⅲa and 16 in stage Ⅲb, and they were treated with neoadjuvant chemotherapy combined with breast-conserving surgery. The clinical efficacy [complete response (CR), partial response (PR), stable disease (SD) and progress disease (PD)] was observed during follow-up. Results　All the patients were followed-up for 12-60 months with a median of 34 months. There were 12 CR patients (14.8%), including 4 with pathological complete response (4.9%), and 52 PR patients (64.2%), 17 SD patients (21.0%). No PD was observed. The overall response rate(ORR) was 79.0%(64/81). After follow-up for 12-60 months (median 34 months), distant metastasis to the lung, liver, meninges and bone occurred in 3 patients (3.7%, 3/81) and 1 of them died. Forty-eight patients received breastconserving surgery. The local recurrence rate was 6.3% (3/48). Assessment of cosmetic result was carried out in 48 patients who received breast-conserving surgery and comprehensive treatment for one year, and excellent results were obtained in 14.6% (7/48), good in 43.8% (21/48), and poor in 41.7% (20/48). Conclusions　The therapeutic efficacy of locally advanced breast cancer is satisfactory by neoadjuvant chemotherapy and breast-conserving surgery. Standardization of excision and postoperative radiotherapy, systemic comprehensive treatment is the key to the success of the treatment. DOI: 10.11855/j.issn.0577-7402.2015.06.14