Background: The purpose of this study was to assess the effectiveness and safety in patients with benign phyllodes after performing local excision and following with intra-operative breast flap reconstruction. Methods: Patients (n = 32) with eligible breast cystosarcoma phyllodes underwent wide local excision followed by intra-operative breast flap reconstruction. Primary outcome measures included average operative time, length of in-hospital stay, postoperative recurrence, and intra-operative and postoperative complications. Results: Thirty-two patients who underwent surgical excision and oncoplastic breast surgery were evaluated using the BCCT. core software. A satisfactory symmetrical breast shape was achieved. The average operative time was 56.3 +/- 8.2 min. The average postoperative duration of hospitalization was 3.7 +/- 1.2 days. While there was no breast disease recurred during the 1 to 8-year follow-up period. Conclusions: Wide local excision accompanied by intra-operative breast flap reconstruction could be adopted for removing benign phyllodes tumors while retaining the basic shape of the breast.