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Background Pure mucinous carcinoma breast cancer (PMBC) is a relatively rare subtype cancer of breast malignancy and associated with favorable prognosis. This retrospective study aims to investigate clinical, pathological features and clinical long-term outcomes. Methods A retrospective review of 56 patients' files with pure mucinous breast cancer was performed. We evaluated the clinic-pathologic characteristics and survival status. Results The mean age was 59 years. 37 patients underwent modified radical mastectomy; 14 underwent breast-conserving surgery. The 5-years overall survival (OS) and disease free survival (DFS) rates were respectively 75,3% and 74%. According to univariate analysis for OS, age (p = 0,049), menopausal status (p = 0,024), clinical T stage (p = 0,037), N stage (p = 0,002) and pathological T stage (p = 0,033) were statistically significant factors for survival. The DFS was better in postmenopausal women (p = 0,02), histological tumor size smaller than 20 mm (p = 0,024), and negative lymph nodes (p = 0,049). Conclusion Pure mucinous breast cancer has a favorable prognosis and is characterized by lower tumor grade, higher hormone receptor expression and lower incidence of nodal involvement. Thanks to its good prognosis, this subtype of cancer should be treated less aggressively than invasive ductal carcinoma.