Breast cancer (BC) incidence is increasing in Nigeria, alongside rising levels of obesity and central adiposity. While body mass index (BMI) is commonly used to assess adiposity, it may inadequately capture fat distribution relevant to BC risk. This study examined the associations between multiple anthropometric measures – including BMI, waist circumference (WC), hip circumference (HC), waist-to-hip ratio (WHR), weight and A Body Shape Index (ABSI) – and BC risk among Nigerian women, and evaluated whether WHR and ABSI provide additional predictive value beyond BMI. A hospital-based case-control study was conducted in five public hospitals in Lagos and Abuja, Nigeria, involving 379 women with histologically confirmed BC and 403 cancer-free controls. Standardised protocols were used to obtain anthropometric measurements. WHR was calculated as WC divided by HC, BMI as weight divided by height squared and ABSI as WC/(BMI²⁄³ × height¹⁄²). Information on socio-demographic, reproductive and lifestyle factors was collected through semi-structured interviews. Multivariable unconditional logistic regression models were used to estimate adjusted odds ratios (ORs) and 95% confidence intervals (CIs), with analyses stratified by menopausal status and trend tests conducted across tertiles. Among premenopausal women, a high WHR was associated with an increased risk of BC (OR 2.26, 95% CI: 1.12–4.58), whereas higher BMI was inversely associated with risk (OR 0.44, 95% CI: 0.20–0.96). ABSI demonstrated a modest positive trend across tertiles among all women (p-trend = 0.038). No statistically significant associations were observed between anthropometric measures and BC risk among postmenopausal women. These findings suggest that measures of central adiposity, particularly WHR, may be more relevant than BMI for assessing BC risk among premenopausal Nigerian women. Interventions aimed at reducing visceral fat accumulation may contribute to lowering the burden of early-onset BC in this setting.