Endometrial cystic hyperplasia needs to be treated or left untreated as the case may be. For asymptomatic hyperplasia, regular checkups are sufficient, and treatment as prescribed by the doctor may be required if discomfort occurs. Endometrial hyperplasia is categorized into simple, complex and atypical hyperplasia. Cystic endometrial hyperplasia is simple endometrial hyperplasia. There is a continuum of pathological changes from endometrial simple hyperplasia to endometrial atypical hyperplasia and then to highly differentiated endometrial cancer, and endometrial atypical hyperplasia is a precancerous lesion of endometrial cancer. For high-risk patients with prolonged abnormal uterine bleeding, anovulation, obesity, and exogenous estrogen use, the risk of cancer is increased, and progestin therapy is recommended to correct abnormal uterine bleeding, reverse the endometrium, and prevent endometrial cancer. Therefore, treatment is needed for endometrial cystic hyperplasia with symptoms, but for asymptomatic hyperplasia, regular review is needed to ensure that the progression of the disease is under control, and consultation with a healthcare professional is recommended to formulate a treatment plan.