Abstract: Breast reconstruction surgery is a common method in the comprehensive treatment of breast cancer. With advancements in surgical techniques and materials, postoperative simulated breast reconstruction has become an achievable goal. In order to address the current issues associated with the surgery, breast plastic surgeons are actively researching tissue engineering technology. Fat tissue engineering, as an emerging technique, provides a potential solution for unmet clinical demands in breast reconstruction based on the experience of autologous fat transplantation, biology, and tissue engineering. It represents an important advancement in the field of comprehensive treatment for breast tumors. Fat tissue engineering allows for the preparation of biomimetic soft tissues, offering new possibilities for breast reconstruction. By seeding stable, low immunogenic seed cells onto scaffolds, fat tissue engineering can construct biologically active scaffolds, facilitating the regeneration and repair of fat tissue. Among them, nanofiber scaffolds prepared using electrospinning technology exhibit excellent extracellular matrix structure and mechanical properties. They not only provide space for the growth of fat tissue, but also regulate cell phenotype and initiate interactions with the extracellular matrix, serving as an induction platform for cell differentiation and proliferation. Therefore, electrospun nanofiber scaffolds are considered promising materials in fat tissue engineering. This paper reviews the research progress of bioactive electrospun nanofiber scaffolds in breast fat tissue engineering, aiming to better understand the development trends of breast reconstruction surgery and provide guidance and reference for future clinical applications.