The tight-junction protein claudin-9 (CLDN9) is barely distributed in normal adult tissues but is ectopically expressed in various cancer types. Although multiple databases indicated upregulation of CLDN9 in endometrial cancers at the mRNA level, its protein expression and biological roles remain obscure. In the present study, the prognostic significance of CLDN9 expression in endometrial cancer was evaluated by immunohistochemical staining and semi-quantification using formalin-fixed paraffin-embedded specimens obtained from 248 endometrial carcinoma cases. A total of 43 cases (17.3%) had high CLDN9 expression, whereas 205 cases (82.7%) exhibited low CLDN9 expression. The 5-year disease-specific survival rates in the high and low CLDN9 expression groups were 62.8 and 87.8% (P<0.001), respectively. In addition, multivariate analysis revealed that high CLDN9 expression was an independent prognostic factor (hazard ratio, 4.99; 95% CI, 1.96-12.70; P<0.001). Furthermore, CLDN9 expression was significantly correlated with the expression of CLDN6 (P<0.001), which is the closest CLDN member to CLDN9 and a poor prognostic factor for endometrial carcinoma. The 5-year disease-specific survival rate of cases with CLDN6-high/CLDN9-high, CLDN6-high/CLDN9-low and CLDN6-low/CLDN9-high status was 30.0, 37.5 and 72.7%, respectively, whereas that of CLDN6-low/CLDN9-low was 89.8% (P=0.004). In conclusion, aberrant CLDN9 expression is a predictor of poor prognosis for endometrial cancer and may be utilized in combination with CLDN6 to achieve higher sensitivity. Recent studies by our group demonstrated that aberrant CLDN6 expression is a biomarker for poor prognosis in endometrial cancer, and that abnormal CLDN6 signaling enhances malignant behaviors by AKT-dependent phosphorylation of estrogen receptor-α (ERα) through the Src-family kinases (SFK)/PI3K/AKT signaling pathway (15-17). Among CLDN subtypes, CLDN9 is the closest member to CLDN6 (18) and