The breast wheel, which was developed in the late middle ages, is somewhat of a compromise between the inefficient undershot wheel and the highly efficient but limited overshot wheel.

Like the overshot wheel it has buckets on its rim, but they face in the opposite direction. Water fills the buckets at the mid-point—or breast—of the wheel. The water's dead weight causes the wheel to turn. Often a concave shell, also known as a breast, is fitted near the underside of the wheel to keep water in the buckets until it reaches the bottom of the wheel, thereby increasing efficiency. The breast wheel can operate over a wider variety of water levels than can the overshot wheel, and does better in backwater conditions. Its large diameter requires gears to increase rotational speed when needed.

Versatility and moderate efficiency made the breast wheel the workhorse of American industry in the early 1800s.