INTRODUCTION: Primary breast reconstructive surgery is performed after mastectomy and is an important part of comprehensive management of breast cancer. It offers an attempt to restore the body image AIM: To study surgical outcome of immediate breast reconstruction regarding breast size and shape, comparison to contralateral breast, patient satisfaction and complications of various procedures. MATERIALS AND METHODS: This retro–prospective study was conducted at Sher–i–Kashmir Institute of Medical Sciences in the Department of Burns, Plastic and Reconstructive Microsurgery. It included all the cases operated for early stage breast cancer in which immediate breast reconstruction was done from September 2005 to October 2013.RESULTS: The mean age of the patients was 43.1 years, and pathological results were: invasive ductal carcinoma (n = 27, 90%) and invasive lobular carcinoma (n = 3, 10%). All patients after IBR(immediate breast reconstruction) received adjuvant therapy. After a mean follow–up of 1.5 years, no local recurrence occurred. Main complications were seroma (n = 3, 10%), scarring (n = 3, 10%), and partial flap necrosis (n = 1, 3.33%). 25 (83.3%) patients  reported their degree of satisfaction as good, while as 22 (73.3%) patients were found to have  good cosmesis after proper assessment. CONCLUSION: Primary breast reconstruction can be performed safely with good cosmetic results and enhanced quality of life.