The aim of the present study was to analyze whether pretherapeutic hysteroscopy increases the recurrence rate in patients with endometrial cancer confined to the uterus. Between January 1993 and December 1995 a total of 33 patients with endometrial carcinoma underwent surgical staging following diagnostic fluid hysteroscopy and curettage at our department. Twenty-seven patients who had disease confined to the uterus without involvement of the uterine serosa formed the study group. Fifty-five patients with endometrial carcinoma confined to the uterus who had undergone surgery after diagnostic curettage without hysteroscopy during the same period were identified as controls. The median follow-up in the hysteroscopy group and the controls was 29 months (range 26-46) and 30 months (range 10-48), respectively. In the hysteroscopy group, no patient died of disease but one patient (3.7%) developed a local recurrence 37 months after primary treatment. In the control group, one patient (1.8%) had a local and para-aortic recurrence 20 months after primary treatment. Preceding diagnostic fluid hysteroscopy does not seem to increase the risk of early recurrence in patients with endometrial carcinoma histologically confined to the uterus.