Objective To analyze the value of ultrasound imaging features and blood flow parameters in differentiating luminal and triple-negative breast cancer.Methods Clinical data of 46 patients with luminal breast cancer and 23 patients with triple-negative breast cancer treated at our hospital from June 2022 to May 2023 were retrospectively analyzed. Conventional ultrasound, three-dimensional grayscale imaging, and three-dimensional power Doppler imaging, as well as immunohistochemical analysis, were performed for all patients. The ultrasound imaging characteristics and blood flow parameters of the two groups were compared. The influencing factors for luminal breast cancer and the diagnostic efficacy of ultrasonic imaging features and blood flow parameters for luminal and triple-negative breast cancer were analyzed.Results The luminal-type group had a significantly higher proportion of lesions with round or oval shapes, smooth margins, and circumferential blood flow distribution compared to the triple-negative group (P < 0.05). In contrast, the proportions of lesions with posterior acoustic enhancement, well-defined borders, and convergence sign were significantly lower in the luminal-type group than in the triple-negative group (P < 0.05). The levels of MG, MP, R and VFI in the luminal-type group were all higher than those in the triple-negative group (P < 0.05). Multivariable Logistic regression analysis showed that morphology [O^R = 3.683 (95% CI: 1.283, 10.577) ], border [O^R = 8.829 (95% CI: 3.018, 25.830) ], margin [O^R = 2.910 (95% CI: 1.436, 5.896) ], convergence sign [O^R = 8.820 (95% CI: 1.849, 42.062) ], MG [O^R = 1.101 (95% CI: 1.010, 1.200) ], MP [O^R = 1.088 (95% CI: 1.000, 1.183) ], R [O^R = 6.780 (95% CI: 2.317, 19.837) ], and VFI [O^R = 16.087 (95% CI: 5.498, 47.065) ] were all influencing factors for luminal breast cancer (P < 0.05). The ROC curve analysis revealed that the area under the curve of ultrasound imaging features combined with blood flow parameters in differentiating luminal from triple-negative breast cancer was 0.967 (95% CI: 0.931, 1.000), with the sensitivity being 97.80% (95% CI: 0.892, 0.993) and the specificity being 95.70% (95% CI: 0.875, 0.989).Conclusion Ultrasound imaging features and blood flow parameters exhibit different characteristics between luminal and triple-negative breast cancer, demonstrating good diagnostic value and providing a useful reference for the differential diagnosis of breast cancer.