Pseudoangiomatous stromal hyperplasia (PASH) is a benign breast condition of collagen proliferation. In this article, four cases are presented in series to illustrate the varying clinical presentations of PASH at mammography and sonography, as well as the vastly differing age groups that can be affected. A literature review of the aetiology, pathology and management of PASH is included to provide a comprehensive but succinct overview of the condition, what it is and how to recognise and manage it.