Primary sarcomatoid carcinoma of the uterus is a rare and highly malignant neoplasm with a poor prognosis. Herein, we reported a case of uterine sarcomatoid carcinoma in a 55-year-old woman with colporrhagia for 1 month. 18F-FDG PET/CT showed intense 18F-FDG uptake of the uterine tumor with hypermetabolic pelvic lymph node and pulmonary nodules. Histopathology and immunohistochemistry of the uterine lesion tissue confirmed the diagnosis of sarcomatoid carcinoma after needle biopsy.