BACKGROUND: Endometrial cancer is the most common cancer of the female genital tract. No effective biomarkers currently exist to allow for an efficient risk classification of endometrial carcinoma or to direct treatment (adjuvant radiation and/or chemotherapy) or to triage pelvic and para-aortic lymphadenectomy. L1 cell adhesion molecule (L1CAM) a transmembrane protein of the immunoglobulin family that has been implicated in promoting tumor cell proliferation, migration, invasion, and metastasis became an attractive candidate as a potential biomarker in endometrial carcinoma and potential therapeutic target in high-risk groups. OBJECTIVES: Evaluation of L1CAM expression in endometrial carcinoma and correlation of this expression with various pathological parameters. MATERIALS AND METHODS: Immunohistochemical staining for L1CAM was performed on paraffin-embedded sections of 80 cases of endometrial carcinomas that underwent total hysterectomy with bilateral salpingo-oophorectomy. Expression of L1CAM in >10% of tumor cells was interpreted as positive. RESULTS: L1CAM expression was detected in 22.5% of cases and showed statistically significant correlation with non-endometrioid histological type, high grade, high FIGO stage, high pathological (T) stage, cervical involvement, nodal metastasis, lymphovascular space invasion, and high-risk tumor according to the European Society for Medical Oncology system for risk stratification (p < 0.05). CONCLUSION: The high rate of L1CAM expression in high-risk endometrial carcinomas suggests that L1CAM represents a potential marker for the identification of patients needing closer follow-up and aggressive treatment. In addition, its potential role as a therapeutic target for high-risk endometrial cancer seems promising.