It has been long debated whether endometrial cancer must be removed from pelvic and retroperitoneal lymph nodes. There is a view that early-stage endometrial cancer has few lymph node metastases if it is moderately to highly differentiated and invades muscle <1/2. And it is found that lymph node dissection does not improve the five-year survival rate; therefore, it is considered unnecessary to remove lymph nodes in stage endometrial cancer. However, there are also views that pelvic lymph node dissection can reduce the recurrence of endometrial cancer in the pelvis, and that lymph node dissection can clarify the stage and formulate post-surgical adjuvant treatment plan, which can help improve the prognosis, so lymph node dissection is advocated. So should we remove pelvic and para-aortic lymph nodes in clinical practice? A recent study found that pelvic lymph node dissection does not help in the prognosis of early-stage women with endometrial cancer regardless of overall survival or recurrence-free survival, but lymph node dissection has predictive value in that it can more accurately identify the extent of metastasis and the stage of the disease to help in disease assessment and determine prognosis. So, is it possible to assume that lymph node dissection is not necessary for early stage endometrial cancer? In fact, there is still a high rate of lymph node metastasis for patients with combined high-risk factors for lymph node metastasis. Lymph node dissection is recommended if any of the following factors are present: 1. deep muscle invasion is assessed preoperatively or intraoperatively; 2. tumor is hypofractionated; 3. clinical stage II or above; 4. suspicious lymph node metastasis is detected during surgery, or lymph node metastasis is confirmed by biopsy; 5. adnexal invasion; 6. special types (plasma breast cancer and clear cell carcinoma, migratory cell carcinoma).