Objectives: To evaluate the usefulness of power Doppler vocal fremitus (PDVF) breast sonography for differentiation of hamartomas from other breast (malign or benign) masses. Material and methods: Two hundred and six breast masses in 180 women were evaluated. The breast lesions were scanned first by mammography (MG), then by ultrasonography (US) with PDVF imaging. Finally, biopsy was performed on lesions suspicious for malignancy (n = 172). We used PDVF imaging to evaluate whether the Power acoustic Doppler artifact existed in all breast lesions. Results: Pathology results of 172 biopsied lesions showed that 83 were malign and 89 masses were benign. Totally 39 breast hamartomas were diagnosed radiologically (n = 25) or histopathologically (n = 14). All hamartomas (n = 39) produced the power acoustic Doppler artifact as the surrounding tissue at the same depth in PDVF imaging. On the other hand, none of the malign or benign lesions, apart from hamartomas, evidenced a similar vibrational artifact as the surrounding tissue at the same depth in the PDVF imaging. Conclusion: PDVF imaging during breast sonography is an invaluable technique in the identification of breast hamartomas from other benign or malign breast masses.