To compare the cosmetic effect of circumferential areola incision and radial incision in the resection of breast fibroadenoma. Methods From December 2019 to December 2022, 50 patients with breast fibroadenoma diagnosed and operated in Hongren Hospital of Zheng'an County were selected as the research objects. According to different surgical methods, they were divided into control group (24 patients) and observation group (26 patients). The control group was treated with radial incision surgery, and the observation group was treated with circumferential areola incision surgery. The surgical status, surgical scar healing score, shape score, postoperative complications, clinical efficacy and cosmetic effect satisfaction were compared between the two groups. Results The incision length of the observation group was shorter than that of the control group, the intraoperative blood loss was less than that of the control group, and the hospitalization time was shorter than that of the control group (P <0.05), while there was no significant difference in operation time between the two groups (P >0.05). The surgical scar healing score of the observation group was lower than that of the control group, and the appearance score was higher than that of the control group (P <0.05). The incidence of postoperative complications in the observation group was 7.69%, which was lower than 25.00% in the control group (P <0.05). The excellent and good rate of the observation group was 92.31%, which was higher than 79.17% of the control group (P <0.05). The satisfaction score of cosmetic effect in the observation group was higher than that in the control group (P <0.05). Conclusion In the resection of breast fibroadenoma, the implementation of the circumferential areola incision has the advantages of less bleeding, smaller incision, less postoperative complications, shorter hospitalization period, definite curative effect and good cosmetic effect than that of the radial incision.