Objective To explore the pathological manifestations of endometrial adenocarcinoma and to compare them with MRI findings. Methods 16 cases of patients with endometrial adenocarcinoma who were admitted in our hospital between April 2011 and December 2015 were included in the study all of whom were examined by MRI. Surgical and pathological manifestations and MRI findings were summarized. Results The pathological manifestations showed that there were irregular lumpy masses, 12 cases cystic and 4 cases solid. 8 cases were simple type, 6 cases of compound type and 2 cases of mixed type. Under the microscope, the tumor cells showed columnar, adenoid or papillary arrangement, with large nuclear deeply stained and mitotic figure was common. MRI findings: there was space occupying effect in all lesions. Bladder, uterus, peripheral intestine and other organs were pressed and shifted, with ascites. 12 cases were with clear boundaries and 4 cases with fuzzy ones. There were multiple tortuous blood vessels and wall nodules. Cystic fluid showed homogeneous equal or high signal on T1WI and endometrium thickened. The diameter of masses was 3.7-16.3 cm. MRI plain scan showed 13 cases of cystic solid mass and 3 cases of solid mass. Enhanced scan showed that 13 cases of solid parts were with patchy significant enhancement, 3 cases with mild and moderate enhancement. Conclusion MRI findings of endometrial adenocarcinoma have certain characteristics, and cystic and solid masses are common. Boundaries are clear and ascites and mass effect are obvious. There are wall nodules and endometrial thickening. After enhanced scan, the solid parts shows patchy significant enhancement, which is of great value in localization qualitation and differential diagnosis of endometrioid adenocarcinoma. Its diagnosis depends on pathological examination.