De novo or acquired resistance to endocrine therapy limits its utility in a significant number of estrogen receptor-positive (ER-positive) breast cancers. It is crucial to identify novel targets for therapeutic intervention and improve the success of endocrine therapies. Splicing factor 3b, subunit 1 (SF3B1) mutations are described in luminal breast cancer albeit in low frequency. In this study, we evaluated the role of SF3B1 and SF3B3, critical parts of the SF3b splicing complex, in ER-positive endocrine resistance. To ascertain the role of SF3B1/SF3B3 in endocrine resistance, their expression levels were evaluated in ER-positive/endocrine-resistant cell lines (MCF-7/LCC2 and MCF-7/LCC9) using a real-time quantitative reverse transcription PCR (qRT-PCR). To further determine their clinical relevance, expression analysis was performed in a cohort of 60 paraffin-embedded ER-positive, node-negative breast carcinomas with low, intermediate, and high Oncotype DX recurrence scores. Expression levels of SF3B1 and SF3B3 and their prognostic value were validated in large cohorts using publicly available gene expression data sets including The Cancer Genome Atlas. SF3B1 and SF3B3 levels were significantly increased in ERa-positive cells with acquired tamoxifen (MCF-7/LCC2; both Po0.0002) and fulvestrant/tamoxifen resistance (MCF-7/LCC9; P ¼ 0.008 for SF3B1 and P ¼ 0.0006 for SF3B3). Expression levels of both MCF-7/LCC2 and MCF-7/LCC9 were not affected by additional treatments with E2 and/or tamoxifen. Furthermore, qRT-PCR analysis confirmed that SF3B3 expression is significantly upregulated in Oncotype DX high-risk groups when compared with low risk (P ¼ 0.019). Similarly, in publicly available breast cancer gene expression data sets, overexpression of SF3B3, but not SF3B1, was significantly correlated with overall survival. Furthermore, the correlation was significant in ER-positive, but not in ER-negative tumors.This is the first study to document the role of SF3B3 in endocrine resistance and prognosis in ER-positive breast cancer. Potential strategies for therapeutic targeting of the splicing mechanism(s) need to be evaluated. The process of alternative splicing results in synthesis of multiple mRNA variants from a single gene. Earlier studies reported the importance of splice variants in a number of key genes regulating signaling pathways such as apoptosis, metabolism, and angiogenesis. Alterations in expression of some splicing factors, genes that regulate splicing process of mature messenger RNA species from primary transcripts, have also been reported in various cancers including breast cancer. 1 The utilization of next-generation sequencing technologies have further revealed the presence of somatic mutations in splicing factors. 2 Among them, the SF3B1 mutations occurred in several types of hematological malignancies as well as in solid cancers, such as breast, pancreatic cancers, and uveal melanomas. [3][4][5][6][7] These mutations were shown to be