Endometrial thickening with uneven echogenicity is a possibility of cancer, and the chance of cancer needs to be analyzed according to the patient’s specific situation. Endometrial thickening can be caused by endometrial hyperplasia, inflammatory diseases of the endometrium, endometrial polyps and other diseases. However, endometrial thickening is reversible and can be normalized by treating the primary disease or keeping the endometrium in a stable benign state without further development. In the case of endometrial cancer, the cancer cells will stimulate the endometrial hyperplasia to become malignant. Therefore, the chance of endometrial cancer with thick and uneven echogenicity is related to the duration of the disease and the treatment measures. If the duration of the disease is short and the condition is mild, and active treatment measures are taken, the chance of cancer is low; if the duration of the disease is long and the condition is serious, the chance of cancer is relatively high.