Bloody nipple discharge is a rare but distressing finding in neonates and infants. We report on a 2-month-old boy with unilateral bloody nipple discharge. Ultrasound examination revealed dilated mammary ducts. This benign phenomenon is most likely to be caused by mammary ductal ectasia. Invasive investigations or surgery should be avoided in neonates or infants with bloody nipple discharge unless the discharge is unilateral, spontaneous, persistent and accompanied with a palpable mass. Otherwise only serial clinical follow-up is recommended until spontaneous resolution.