PURPOSE: This study examined the yield of mammographically detected calcifications following a stereotactic vacuum-assisted biopsy (SVAB) using an upright add-on type stereotactic device. MATERIALS AND METHODS: Ninety-two women underwent a SVAB between April 2002 and December 2005, and 90 calcifications obtained by the SVAB were evaluated retrospectively. The calcification retrieval rate was examined. The false negative and underestimation rates were determined by comparing the biopsy results with the results from surgery and follow-up mammography. RESULTS: The calcification retrieval rate was 97.8% (90/92). The histopathology of the 90 lesions was benign for 66 (73.3%), borderline for 3 (3.3%) and malignant for 21 (23.3%). A total of 22 malignancies were confirmed surgically. SVAB had a false negative rate of 4.5 % (1/22). The underestimation rate of a surgically excised atypical ductal hyperplasia (ADH) and of ductal carcinoma in situ (DCIS) was 50% (1/2) and 10% (2/20), respectively. CONCLUSION: The use of SVAB with an upright add-on type stereotactic device is an efficient biopsy method for mammographically detected microcalcifications, with low false negative and high calcification retrieval rates.