Objective To analyze the effect of sentinel lymph node biopsy (SLNB) combined with oncoplastic breast-conserving surgery on breast aesthetics in patients with early breast cancer. Methods A total of 80 female patients with early breast cancer treated in Hejian Hospital of Traditional Chinese Medicine from October 2021 to October 2022 were selected as the research subjects. According to different surgical plans, they were divided into the control group and the observation group, with 40 patients in each group. The control group received SLNB combined with conventional breast-conserving surgery, and the observation group received SLNB combined with oncoplastic breast-conserving surgery. The detection of positive sentinel lymph nodes, breast aesthetics, complication rate and long-term survival rate were compared between the two groups. Results There was no signiffcant difference in the detection of positive sentinel lymph nodes between the two groups (P>0.05). The breast aesthetics of the observation group (95.00%) was higher than that of the control group (72.50%) (P<0.05). The incidence of complications in the observation group (7.50%) was lower than that in the control group (30.00%) (P<0.05). There was no signiffcant difference in long-term survival rate between the two groups (P>0.05). Conclusion The combination of SLNB and oncoplastic breast-conserving surgery can positively improve breast aesthetic effect and reduce the risk of complications, without affecting the accuracy of lymphatic screening or long-term survival rate.