Objective To investigate the predictive value of controlled nutritional status (CONUT) for tumor recurrence and metastasis of breast cancer patients. Method The clinicopathological features and survival follow⁃up data of 168 breast cancer patients who underwent surgical resection in Rugao People􀆳s hospital from April 2013 to August 2019 were retrospectively collected. CONUT score was calculated based on the lymphocyte count in the peripheral blood, preoperative serum albumin and total cholesterol levels. All patients were divided into high CONUT (≥3 points) and low CONUT (<3 points) based on the preoperative CONUT score. Chi square test was used to evaluate the relationship between CONUT score and clinicopathological features of breast cancer patients. Kaplan⁃Meier curves were plotted, and the univariate and multivariate Cox regression analysis were conducted to investigate the prognostic value of CONUT score for breast cancer patients. Result High CONUT (≥3 points) was significantly associated with advanced T stage (χ２= 6.666, P=0.036) and lymph node metastasis(χ２ = 4.562, P=0.033). Kaplan⁃Meier curves showed that breast cancer patients with CONUT ≥3 had a higher risk of recurrence and metastasis than those with CONUT <3, and the 5⁃year recurrence⁃free survival (RFS) of the two groups was 78.6% and 96.0%, respectively (χ２=11.562, P=0.001). Subgroup analysis further demonstrated that CONUT ≥3 was markedly correlated to poor RFS of breast cancer patients, regardless of TNM Ⅰ-Ⅱ (5⁃year RFS: 82.6% vs 96.3%; χ２= 4.424, P=0.035) and stage Ⅲ (5⁃year RFS: 40.9% vs 89.1%; χ２= 9.103, P=0.003). The results of univariate and multivariate analysis revealed that T stage (HR=3.875, 95%CI=1.080-13.903, P=0.038), lymph node metastasis (HR=3.354, 95%CI=1.166-9.645, P=0.025) and CONUT (HR=3.003, 95%CI=1.168-7.720, P=0.022) were independent predictors of recurrence and metastasis in breast cancer patients. Conclusion CONUT could be used as an useful predictor of recurrence and metastasis in breast cancer patients.