Objective: To compare the diagnostic accuracy between dilatation and curettage (D&C) pathology and post- surgical gross pathology results in the patients of endometrial carcinoma. Methods: 217 clinical data of patients who were diagnosed as endometrial carcinoma both by D&C and post-surgical gross pathology were collected, compared by the type of organization and histological grade to evaluate the accuracy of D&C pathology. Results:There were 196 endometrioid and 21 non-endometrioid carcinoma of the D&C pathology respectively, the sensitivity 97.4% and specificity 72.7%, Kappa value was 0.716 compared with the post-surgical gross pathology. The numbers of patients with grade 1, grade 2 and grade 3 were 135, 50 and 32 by D&C pathology. Compared with the post-surgical gross pathology, the weighted Kappa value was 0.596 (Z=11.72, P= 0.000). The misdiagnosis rate by D&C was significantly higher in grade 3 versus grade 1 and it was not significant in grade 2 versus the other two groups. Conclusions: Pre-surgical D&C pathology is very helpful and important in the pre-surgical evaluation of endometrial carcinoma, type of organization reveals higher consistency and grade 3 has much higher misdiagnosis rate compared with the grade 1 groups by D&C. [ABSTRACT FROM AUTHOR]