Endometrial cancer (EC) in young and especially null gravid women is a challenging problem with increasing frequency due to both detailed investigations for infertile couples seeking treatment in in vitro fertilization centers and women delaying their plans for pregnancy. Considering very low number of such cases in the literature, fertility-sparing therapy for EC in young women is not standard, although it is widely used. In this review we searched the relevant literature, reviewed selection criteria, therapeutic options, response rates to therapy, special challenges, reproductive outcomes, and follow-up strategies for young women diagnosed with EC.