Objective To investigate and explore the awareness and willingness of breast cancer screening between Han and Mongolian women in Ordos, Inner Mongolia Autonomous Region, and to analyze the influence factors. Methods The patients answered investigation questionnaires face to face, and the content of questionnaire included demographic information, breast cancer awareness and relevant affecting factors on the awareness and willingness. Results 11162 (88.2 %) Han women and 1495 (11.8 %) Mongolian women were enrolled in the survey, with the average age of (45.4 ±7.1) years old and (45.4 ±6.8) years old. The education level (high school and above) of Han women was lower than that of Mongolian women [4456 women (40.0%) vs. 750 women (50.2%), χ2= 57.041, P< 0.001]. The Main way to delivery information on breast cancer screening in Han and Mongolian women was from their family members or friends [5002 women (44.9%) vs. 688 women (46.1%),χ2=40.699, P<0.001]. The proportions of never attending screening in the Han and Mongolian women were 41.7 % (4640 women) and 45.9 % (683 women), respectively (χ2=14.075, P=0.001). The breast self-examination rate of Han women were higher than that of Mongolian [71.1 % (7926 women) vs. 58.5 % (872 women), χ2= 98.466, P< 0.001]. According to logistics regression analysis, the cognitive level of women with high education level and breast disease history was higher (all P<0.001). Conclusions The cognitive level of breast cancer screening in Han women is better than that in the Mongolian, however, the overall level are low. It is necessary to strengthen the propaganda and education, and to encourage women to actively participate in breast cancer screening.