The past two decades have seen an increase in the incidence of endocervical carcinoma. Numerous studies have increased understanding of these tumors; hormonal therapy, human papilloma virus, and other cofactors have been implicated in the etiology of endocervical carcinoma. Early diagnosis is difficult: precursor lesions to adenocarcinoma in situ are still poorly defined and understood, and there may be a rapid transit time from in situ to invasive carcinoma. The definition of microinvasive adenocarcinoma is not uniformly agreed upon, and at this time the recommendation is not to use the term. Histologic typing and grading of adenocarcinoma may be useful in the prediction of prognosis for patients. Therapy is based upon stage of disease, the most beneficial results being obtained from either radical surgery or combination surgery and radiation therapy.