Purpose : To evaluate differential points of patterns of clustered microcalcification between malignant(n=17)and benign(n=46) lesions on mammogram. Materials and Methods : We retrospectively and prospectively evaluatedmammograms of surgically confirmed 63 patients showing clustered microcalcifications. Area, density, number, size, shape of calcification were evaluated along with associated mass and parenchymal distortion. Results : Malignantcalcifications were more variable in size(14/17, 77% vs 25/46, 53%) and shape(11/17, 64.8% vs 13/46, 28.2%). thanbenign counterparts. Pepper, fine granular, branching, comma, tadpole and wormiform calcification were observed inmalignant lesion with statistical significance. The malignant calcifications showed more faint(12/17, 70.5% vs23/46, 50%), irregular margin(17/17, 100% vs 19/46, 42%) and they were usually associated with parenchymaldistortion(16/17, 94% vs 9/46, 20%) and ill-defined masses(10/17, 58.9% vs 12/46, 26.1%). Conclusion: Clusteredmicrocalcifications with variable size and shape , faint or irregular margin, parenchymal distortion, ill definedmasses seen on mammography suggest malignancy.