Adenocarcinoma of the endometrium is the most common malignancy of the female genital tract in the United States. Conversely, uterine sarcomas, also included in these guidelines, are uncommon malignancies. Many physicians believe that adenocarcinoma of the endometrium is a relatively benign disease because of the early symptoms of irregular vaginal bleeding, the often-localized nature of the disease, and the generally high survival rate. However, the estimated number of deaths from endometrial cancer continues to increase, indicating the need for a critical reassessment of the guidelines for managing it. Updates of the uterine neoplasms guidelines for 2009 include expanded recommendations for systemic therapy for recurrent, metastatic, and high-risk endometrial disease; updated recommendations for systemic therapy for uterine sarcoma; and new principles of radiation therapy in both endometrial carcinoma and uterine sarcoma. © Journal of the National Comprehensive Cancer Network.