Endometrial cancer (EC) is the second most common malignant tumor of the female reproductive system, and it occurs in the peri- and post-menopausal periods. The metastasis routes of EC include direct spread, hematogenous metastasis and lymph node metastasis. Symptoms such as vaginal discharge or irregular vaginal bleeding may occur in the early stage. The pathological stage of the patients treated at this time is mostly in the early stage, and comprehensive treatment such as surgery, radiotherapy and chemotherapy can improve the prognosis. This article investigates whether endometrial cancer requires pelvic and para-aortic lymph node dissection. The clinical data of 228 patients with endometrial cancer who underwent pelvic lymphadenectomy in our hospital from July 2020 to September 2021 were retrospectively analyzed. All patients underwent preoperative clinical staging and postoperative pathological staging. This paper compared lymph node spread rates of endometrial carcinoma in different stages, depth of muscle invasion, and pathological characteristics to analyze lymph node metastasis risk factors. Results showed metastasis rates of 7.5% in 228 cases of endometrial cancer, increasing with deeper myometrial invasion. Different clinicopathological factors had varying lymph node spread rates. Different clinicopathological factors have different pelvic lymph node spread rates in surgical patients. The lymph node spread rate of differentially differentiated carcinoma is higher than that of well-differentiated carcinoma. The lymph node spread rate of serous carcinoma is 100%, but there is no difference between the lymph node metastasis rate of special type carcinoma and adenocarcinoma. Statistical significance (