Breast cancer is the leading cause of cancer-related deaths in women in developing countries. The aim of this systematic review was to evaluate long-term outcomes and prognostic factors of pulmonary metastasectomy in patients with breast cancer. A comprehensive search was performed in the MEDLINE, Web of Science, and Scopus databases using selected keywords. All studies regarding the outcomes and prognostic factors of pulmonary metastasectomy in patients with breast cancer between April 1990 and April 2016 were included in this review. Disease-free interval was identified as a prognostic factor in 10, size of metastasis in three, number of metastases and width of resection in five, and hormone receptor status in six studies. According to our study results, disease-free interval, hormone receptor status, number of metastases, width of metastatic resection and size of metastases, in a descending order, are important prognostic factors for pulmonary metastasectomy in patients with breast cancer.