The European Society of Gynaecological Oncology (ESGO), the European Society for Radiotherapy and Oncology (ESTRO), and the European Society of Pathology (ESP) have jointly updated their evidence-based guidelines for the management of endometrial carcinoma. The guidelines aim to improve the quality of care for women with endometrial carcinoma across Europe and worldwide. Endometrial carcinoma is the most common gynecological cancer in Europe, with a 5-year prevalence of 34.7%. The guidelines cover new topics and provide comprehensive advice on diagnosis and treatment in a multidisciplinary setting. Key recommendations include: 1. **Planning and Treatment**: Staging and treatment planning should be multidisciplinary and based on comprehensive knowledge of prognostic and predictive factors. 2. **Germline Mutations**: Testing for mismatch repair (MMR) status and microsatellite instability (MSI) is recommended to identify patients at higher risk for Lynch syndrome and to guide treatment decisions. 3. **Molecular Classification**: Molecular classification is encouraged for all endometrial carcinomas, especially high-grade tumors, to guide treatment decisions. 4. **Prognostic Risk Groups**: Prognostic risk groups are defined based on histopathologic type, grade, myometrial invasion, and lymphovascular space invasion (LVSI). 5. **Pre- and Intra-Operative Work-Up**: Preoperative assessments include family history, general health, and imaging modalities to assess metastatic disease. 6. **Surgical Management**: Minimally invasive surgery is preferred for early-stage disease, and standard surgical procedures include total hysterectomy with bilateral salpingo-oophorectomy. 7. **Adjuvant Treatment**: Adjuvant treatments, including brachytherapy, external beam radiation therapy (EBRT), and chemotherapy, are recommended based on the prognostic risk group. 8. **Special Considerations**: Recommendations are provided for medically unfit patients, fertility preservation, and synchronous presentation of endometrial and ovarian carcinomas. The guidelines emphasize the importance of multidisciplinary collaboration and individualized treatment approaches to improve patient outcomes.The European Society of Gynaecological Oncology (ESGO), the European Society for Radiotherapy and Oncology (ESTRO), and the European Society of Pathology (ESP) have jointly updated their evidence-based guidelines for the management of endometrial carcinoma. The guidelines aim to improve the quality of care for women with endometrial carcinoma across Europe and worldwide. Endometrial carcinoma is the most common gynecological cancer in Europe, with a 5-year prevalence of 34.7%. The guidelines cover new topics and provide comprehensive advice on diagnosis and treatment in a multidisciplinary setting. Key recommendations include: 1. **Planning and Treatment**: Staging and treatment planning should be multidisciplinary and based on comprehensive knowledge of prognostic and predictive factors. 2. **Germline Mutations**: Testing for mismatch repair (MMR) status and microsatellite instability (MSI) is recommended to identify patients at higher risk for Lynch syndrome and to guide treatment decisions. 3. **Molecular Classification**: Molecular classification is encouraged for all endometrial carcinomas, especially high-grade tumors, to guide treatment decisions. 4. **Prognostic Risk Groups**: Prognostic risk groups are defined based on histopathologic type, grade, myometrial invasion, and lymphovascular space invasion (LVSI). 5. **Pre- and Intra-Operative Work-Up**: Preoperative assessments include family history, general health, and imaging modalities to assess metastatic disease. 6. **Surgical Management**: Minimally invasive surgery is preferred for early-stage disease, and standard surgical procedures include total hysterectomy with bilateral salpingo-oophorectomy. 7. **Adjuvant Treatment**: Adjuvant treatments, including brachytherapy, external beam radiation therapy (EBRT), and chemotherapy, are recommended based on the prognostic risk group. 8. **Special Considerations**: Recommendations are provided for medically unfit patients, fertility preservation, and synchronous presentation of endometrial and ovarian carcinomas. The guidelines emphasize the importance of multidisciplinary collaboration and individualized treatment approaches to improve patient outcomes.