Background: In the past decade, changing attitudes towards breast reconstruction among both patients and care providers have led a growing number of women to seek breast reconstruction after mastectomy. The present work assesses the effect of immediate breast reconstruction (IBR) and no breast reconstruction on the psychological impact of patients undergoing mastectomy. Materials and Methods: Data were collected prospectively on 120 patients between 2008 and 2014. Standard questionnaires were used to determine the psychological impact suffered by patients who underwent IBR (60 patients) and no reconstruction (60 patients), their degree of satisfaction with the results achieved, and their post-procedure opinions regarding reconstruction options. Results: A total of 120 women were included in the study (60 had only mastectomy and 60 had mastectomy with immediate breast reconstruction). Between two study groups age was comparable (20-50 years- mean age of 37.42 and 39.57 years in reconstruction and non reconstruction group respectively). A significantly greater proportion of the women who underwent no reconstruction suffered psychological problems (anxiety,depression,low self-esteem) than those who underwent reconstruction (P = 0.001). Some 86.66% (52) of the women who underwent IBR maintained a post-procedure preference for this option and had positive psychological impact of IBR procedure in them, while in no reconstructive group only 20.0% (12) women had positive psychological impact. 83.66% (50) in reconstructive group had good post-reconstruction breast cosmesis, and 16.33% (10) had fair cosmesis. Conclusions: The women who underwent only mastectomy suffered more emotional problems than those who underwent a reconstruction procedure. In general, all groups reported a post-procedure preference for IBR in their questionnaire answers. The aesthetic results achieved by IBR seem to be those best accepted.