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Male breast cancer (MBC) is a rare disease, accounting for less than 1% of all breast cancer cases. Sentinel lymph node biopsy (SLNB) has emerged as a less invasive alternative to axillary lymph node dissection (ALND) for axillary staging in breast cancer, offering reduced morbidity and comparable accuracy. However, the application of SLNB in MBC remains underexplored, with limited male-specific data and treatment protocols often extrapolated from female breast cancer studies. Available evidence suggests that SLNB in men demonstrates high diagnostic accuracy, with low false-negative rates and a high sentinel lymph node identification rate. Despite this, there is ongoing debate about its long-term impact on clinical outcomes, particularly for patients with sentinel node metastasis, where ALND may still provide superior survival outcomes in some cases. Predictive tools are being developed to identify better patients who may benefit from SLNB alone, potentially reducing the need for more invasive procedures. As the role of SLNB continues to evolve in MBC management, further prospective research is needed to refine its application and assess its long-term oncologic outcomes.