Objective: To investigate the clinical significance of survivin in endometrial carcinoma and to investigate the relationship between the expression of survivin and Ki-67. Methods: Immunohistochemical S-P (streptavidin-biotin-peroxidase complex)method was performed to detect the expression of survivin and Ki-67 antigen in 15 cases of normal endometrium, 21 cases of endometrial simple and complex hyperplasia, 22 cases of endometrial atypical hyperplasia, and 61 cases of endometrial carcinoma. Results: Survivin was hardly detected in some normal endometrium in the proliferative phase and in the secretory phase. However, the level of survivin expression in atypical hyperplasia endometrium(72.73﹪)was higher than that in normal endometrium (7.14﹪)(P ＜ 0.05), including simple and complex hyperplasia (42.38﹪)(P ＜ 0.01), and was lower than that in endometrial carcinoma (90.17﹪)(P ＜ 0.05). Moreover, significant correlation was present between the expression of survivin and the characteristics of endometrial carcinoma, including clinical stage, histological grade and the presence of invasion to myometrium (P ＜ 0.05). In addition, Ki-67 antigen expression was positively correlated with survivin expression in all specimen. Ki-67 labeled indexes (LIs)in hyperplasia endometrium were significantly lower than those in atypical hyperplasia endometrium and endometrial carcinoma (P ＜ 0.01 ), while there was no significant difference in Ki-67 LIs between atypical hyperplasia endometrium and endometrial carcinoma(P ＞ 0.05). There was no significant relationship between Ki-67 LIs and the characteristics of endometrial carcinoma, including histological grade, clinical stage or the invasion to myometrium(P ＞ 0.05). Conclusion: Survivin may participate in the onset and progression of endometrial carcinoma through inhibiting apoptosis and promoting proliferation. Survivin expression is correlated with the malignant degree and prognosis of tumor. Ki-67 is also associated with carcinogenesis and progression of endometrial carcinoma. The results suggest that survivin could be a diagnostic and prognostic marker for endometrial carcinoma and might provide pathways to treat the patients with recurrent or refractory or rudimental endometrial carcinoma.