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Background: Idiopathic granulomatous mastitis that has not had a clear consensus about its treatment since the day it was identified as a rare, benign inflammatory breast disease that mimics malignancy due to its appearance features., Aims: In our research, we intended to compare the efficiency of intralesional and systemic steroids administration in the treatment of idiopathic granulomatous mastitis., Study Design: Prospective randomized controlled study., Methods: A total of 36 female patients who had been histopathologically diagnosed with idiopathic granulomatous mastitis and whose other factors had been microbiologically excluded were included in the study. The patients were randomized into two sub-groups that would be treated with systemic and intralesional steroids. All patients were evaluated through physical examination one week after the completion of the treatment. Subsequently, the follow-up of the patients was performed thorough physical examination and ultrasonography and/or magnetic resonance imaging at the 1st, 3rd, and 6th months., Results: All patients adapted to treatment. Complete clinical regression occurred in 32 patients, while 30 of 36 patients responded to treatment both radiologically and clinically. A total of 4 patients had minor side effects. It was determined that there was no statistically significant difference between local and systemic steroid groups in terms of complete clinical regression, responded to treatment side effects, and recurrence rates., Conclusion: Intralesional steroid administration was also considered just as a successful treatment method as the systemic steroid administration., Key Words: Idiopathic granulomatous mastitis, Intralesional steroid, Systemic steroid.