Mammography is one of the most commonly used breast imaging methods and the only screening method for breast cancer scientifically proven to be effective. Digital tomosynthesis is a newer method of breast imaging that represents advance over conventional digital mammography. It uses a movable X-ray tube that moves in an arc above the breast, thus allowing multiple images to be obtained per projection, each showing a single layer of breast. Synthetic mammography is a complete two-dimensional display of data obtained by tomosynthesis. By introducing tomosynthesis screening with the addition of synthetic mammography, the detection rate of breast cancer can be increased compared to two-dimensional digital mammography, with approximately the same radiation dose as with digital mammography. The aim of this paper is to present the possibilities of tomosynthesis in relation to two-dimensional digital mammography and to describe its role in screening for breast cancer. Special attention will be paid to its role in imaging of dense breasts, whose mammographic findings have a particularly low specificity and sensitivity. The aim is also to present the latest knowledge related to the progress of tomosynthesis, especially the possibility of biopsy under the supervision of tomosynthesis and the possible application of artificial intelligence in reading the findings of tomosynthesis.