Sentinel node biopsy is an exciting new tool for staging the axilla in an accurate and less morbid way. It is becoming more apparent that sentinel node biopsy is appropriate in a variety of settings. When an experienced multidisciplinary team is present and patients are properly selected sentinel node biopsy can be performed with greater than 95% accuracy. The current data regarding contraindications for the use of sentinel lymph node biopsy and lymphatic mapping is reviewed.