Introduction: Breast cancer is the second most prevalent neoplasm in women after cervical cancer in Peru. It is also the third leading cause of female mortality. The implementation of screening programs using mammography has led to a considerable reduction in the mortality of this cancer in high-income countries. Objectives: To analyze the factors associated with mammography use in Peruvian women between the ages of 40 and 59. Methods: Secondary analysis of the 2018 Demographic and Health Survey in Peru. The national representative sample consisted of 4822 women between the ages of 40 and 59. The main outcome was the use of mammography during the last 24 months, with which we calculated percentages and crude and adjusted prevalence ratios (PR). Results: 16.9% of the surveyed women reported a mammography exam. A higher proportion of mammography use was observed in women with a higher level of education (30.1%), higher wealth quintile (34.2%) and those from capital cities (26.9%). Multivariate analysis showed that only the highest wealth index quintile (prevalence ratio: 5.75; 95% confidence interval: 2.97 to 11.15) compared to the lowest quintile; and the 55 to 59 age group (prevalence ratio: 1.83; 95% confidence interval: 1.31 to 2.55) compared to the 40 to 44 age group, were significantly associated with mammography. Conclusions: The use of mammography as a preventive examination for breast cancer in Peru is still low compared to other countries. The association of mammography with the better-off quintile shows the inequalities of access to preventive health in the country.