Endometrial cancer is the most common gynaecological malignancy, usually diagnosed in post-menopausal women. However, an incidence of 214 % of cases occurring in women <45 years of age has been reported. In this group of younger patients, because of the childbearing challenges, there is an increased percentage of nulliparity. Due to the early disease stage and the low grade of differentiation at the time of diagnosis, an improved prognosis has been reported in this group of patients. Many reports have described conservative treatment of this tumour in selected patients with the aim of preserving fertility. In this article, we review the literature for a better assessment of selection criteria, risk of concomitant neoplasias, hormonal treatment and clinical and reproductive outcome. We have concluded that fertility-preserving management of endometrial cancer is feasible in selected patients with an acceptable clinical and reproductive outcome.