Treatment paradigms for endometrial cancer are rapidly evolving. New minimally invasive surgical techniques have helped to reduce the morbidity of women with early-stage tumors undergoing hysterectomy. A growing body of evidence has helped to stratify women with intermediate-risk endometrial cancer to optimize adjuvant therapy in this subset of patients. For women with high-risk and metastatic endometrial cancer there has been a renewed interest in incorporating chemotherapy into treatment paradigms. This review summarizes the latest advances in the treatment of endometrial cancer with a special focus on adjuvant therapy.