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Skin-sparing mastectomy (SSM) is an appealing treatment option for patients with early-stage breast carcinoma. This article is a review of the literature concerning this innovative technique. Surgery consists in a total mastectomy with preservation of the cutaneous envelope of the breast. This is done by performing the smallest incision possible, e.g., periareolar incision, with ablation of the nipple-areola complex. Mastectomy is followed by immediate reconstruction with a prosthesis and/or flap. Besides complications of reconstruction, the principal postoperative concern is necrosis of the skin flap. SSM seems oncologically safe as studies didn't find any difference in terms of relapse, metastasis and survival when comparing SSM to non-SSM. Nevertheless, the use of this technique remains controversial in advanced stage breast cancer (2B and 3). Finally, SSM is associated with improved aesthetics with a high level of surgeons' and patients' satisfaction.