Neonatal breast enlargements have varying number of presentations on imaging and these have been underreported in the literature. Our case report profiles a 2-week-old female who presented with a history of bilateral breast enlargement with redness and clear, non-bloody, milk-like discharge, who was clinically diagnosed and managed for neonatal mastitis, which was actually a neonatal breast enlargement only. Awareness on neonatal breast enlargement that can be just physiological without any associated mastitis or inflammatory/infective changes can prevent unnecessary hospitalization and treatment with parenteral antibiotics.