Endometrial carcinoma is the most common malignant tumor originating from endometrial epithelium in women. In recent years, the incidence is increasing and the onset age is getting younger. The main treatment methods are still surgery, radiation, and chemotherapy, but the treatment effect of advanced endometrial cancer is not ideal. Therefore, the traditional classification method has serious deficiencies in diagnosis and treatment, and cannot provide sufficient basis for precise treatment of patients. In recent years, with the deepening of molecular biomedical research, a growing number of studies have found the pathogenesis and signaling pathway association of endometrial cancer. The TGF-β/Smads signaling pathway is more clearly associated with endometrial cancer, and it is urgently needed to be included in the routine diagnosis and treatment of patients in clinical practice. A series of studies have shown that it promotes tumor progression mainly by promoting epithelial-mesenchymal transformation, stimulating angiogenesis, inducing immunosuppression, and interacting with tumor microenvironment.