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However, its diagnostic efficacy is often compromised by inherent speckle noise that degrades image quality and obscures underlying anatomical structures. Existing speckle reduction methods tend to over-smooth tissue boundaries and generalize poorly to heterogeneous noise levels. To address these limitations, we propose a Noise-Aware Boundary-Enhanced Generative Learning (NBGL) framework for ultrasound speckle reduction, which simultaneously preserves annotated anatomical boundaries and adapts to varying noise levels. The NBGL framework consists of a speckle reduction branch and a boundary enhancement branch. The former leverages generative learning to suppress speckle noise, while the latter learns boundary-sensitive representations to preserve target anatomical structures. 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The NBGL framework consists of a speckle reduction branch and a boundary enhancement branch. The former leverages generative learning to suppress speckle noise, while the latter learns boundary-sensitive representations to preserve target anatomical structures. 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