Background: Breast-conserving surgery (BCS) is a widely accepted treatment for early-stage breast cancer, aiming to achieve oncological safety while preserving breast aesthetics. The status of tumor margins plays a crucial role in determining recurrence rates. A positive margin increases the risk of local recurrence, necessitating further intervention. This study evaluates the histopathological correlation between tumor margin status and recurrence rates in patients undergoing BCS. Materials and Methods: A retrospective analysis was conducted on 200 patients who underwent BCS. Tumor margins were assessed histopathologically and categorized as negative (≥2 mm clear margin), close (<2 mm), or positive (tumor cells at the inked margin). Patients were followed up for a median period of five years, and recurrence rates were recorded. Statistical analysis was performed using chi-square tests and logistic regression to assess the association between margin status and recurrence. Results: Out of 200 patients, 120 (60%) had negative margins, 50 (25%) had close margins, and 30 (15%) had positive margins. Local recurrence was observed in 5% of patients with negative margins, 20% with close margins, and 45% with positive margins. The statistical analysis showed a significant association between margin status and recurrence rates (p < 0.001). Patients with positive margins had a 3.5-fold increased risk of recurrence compared to those with negative margins. Conclusion: Tumor margin status is a critical factor influencing recurrence rates following BCS. Positive and close margins significantly increase the risk of local recurrence, emphasizing the need for adequate margin clearance and potential re-excision. Histopathological evaluation of margins should be a key consideration in surgical decision-making to improve oncological outcomes.