Objective: To observe the safety and incidence of adverse events of hantreol and Herceptin in human epidermal growth factor receptor-2 (HER2) positive breast cancer. Methods: The clinical data of 58 patients with HER2-positive breast cancer admitted to our hospital from June 2022 to June 2024 were retrospectively collected. All patients received neoadjuvant chemotherapy, on the basis of which, the two groups were treated with different targeted therapies. Hanquyou group was treated with Hanquyou targeted therapy. The herceptin group was treated with herceptin targeted therapy. The efficacy, liver function [alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP)] and adverse events of the two groups were collected and compared. Results: There was no significant difference in clinical effective rate between the two groups (P > 0.05). Before treatment, there were no significant differences in the levels of ALT, AST and ALP liver function indexes between the two groups (P > 0.05). After treatment, the levels of liver function indexes in both groups were significantly increased, but the levels of ALT, AST and ALP in Hanquyou group were significantly lower than those in Herceptin group (P < 0.05). Compared with Herceptin group, the incidence of gastrointestinal reactions and adverse events of electrolyte disturbance in Hantreyou group was significantly decreased (P < 0.05). Conclusion: Hantreu and Herceptin have the same therapeutic effect in patients with HER2-positive breast cancer, but the use of Hantreu has less damage to liver function, lower incidence of adverse events and better safety.