Endometrial cancer (EC) incidence rises with obesity and reproductive changes. EC is categorized into estrogen-dependent and non-estrogen-dependent types, with symptoms like bleeding and pain. Early diagnosis is crucial, though no established screening exists. Endometrial hyperplasia (EH) is a common disorder due to excessive estrogen, often leading to irregular bleeding and infertility. Hysteroscopy is the gold standard for diagnosing EH, with high sensitivity and specificity. EH and EC frequently coexist, with severe atypical hyperplasia (AH) increasing EC risk. Early detection and intervention in AH improve prognosis. This study analyzed 200 patients, finding age ≥ 53.5 years, menopausal status, and severe AH as high-risk factors for EC. The risk of EC increases with the number of high-risk factors. Despite challenges, improving diagnostic methods and training is essential for better outcomes.