Objective: To investigate the expression of hypoxia inducible factor-1 (HIF-1) and E-cadherin in endometrial carcinoma and their correlation with clinicopathological features. Methods: Tissues of 92 cases of type I endometrial adenocarcinoma, 60 cases of atypical endometrial hyperplasia and 60 cases of normal endometrial who were treated in the Hospital of Shanxi Medical University from May 2009 to October 2019 were randomly selected. The expression of HIF-1 and E-cadherin were detected by immunohistochemistry and compared with cancerous tissues, atypical hyperplasia tissues and normal tissues, and the correlation between HIF-1 and E-cadherin and the clinicopathological features of type I endometrial cancer were analyzed. Results: The positive expression rate of HIF-1 in the endometrial adenocarcinoma and atypical hyperplasia was 73.9% and 37.1%, respectively, which was significantly higher than 10% of the normal endometrium with statisticly significant differences (P<0.01); the expression rate of E-cad in endometrial adenocarcinoma was 33.7%, which was lower than 56.5% of the atypical hyperplasia and 93.3% of the normal endometrium, which has significant differences (P<0.01). (P<0.01). HIF-1 was highly expressed in endometrial adenocarcinoma, while E-cad was low and there was a negative correlation between them (r=−0.572, P<0.01). The expression of HIF-1 in type I EC was not related to the age and histological grade of the patients (P>0.05). The expression of E-cad was not related to the age of the patients (P>0.05). Conclusion: the high expression of HIF-1 and the down-regulation of E-cad play an important role in the occurrence and development of endometrial carcinoma. The combined detection of HIF-1 and E-cad plays an important role in the diagnosis of type I EC and the determination of its invasiveness.