Background To determine the ability of contrast-enhanced magnetic resonance imaging (CE-MRI) to predict myometrial invasion, cervical invasion, and pelvic lymph node metastasis in endometrial carcinoma (EC) and to analyze factors that lead to errors in this identification.Methods.We designed a retrospective study.167 women diagnosed with EC.All patients received a preoperative CE-MRI scan.Histopathologic findings was used as the definitive diagnosis.Results The results were compared with histopathologic findings, factors that make accurate assessment of myometrial invasion, cervical invasion, and pelvic lymph node metastasis difficult by CE-MRI were analyzed.Results.The sensitivity, specificity, diagnostic accuracy, positive predictive values, and negative predictive values of CE-MRI were 90.9, 91.8, 91.6, 73.2 and 97.6%, respectively,for identifying deep myometrial invasion;84.2, 96.0, 94.6, 72.7 and 97.9%, respectively, for identifying cervical invasion;and 45.0, 91.2, 85.6, 40.9 and 92.4%, respectively, for identifying pelvic lymph node metastasis.The main causes of error in CE-MRI were myomas, cornual lesions, deep myometrial invasion, large tumor size, non-endometrioid tumor type and lower tumor grade.Conclusions CE-MRI has a high accuracy and a low tendency to produce false negative predictive values.Gynecologic oncologists should combine the imaging data and clinical information to make the therapeutic decisions and avoid diagnostic errors.