Endometrial cancer is the most common reproductive cancer in women in developed countries and the fourth most common cancer overall. The cumulative risk in more developed countries is 1.58%, compared to a cumulative risk of 0.67% in less developed regions. Many epidemiologic studies have been performed to determine the risk factors for endometrial cancer and the degree to which they influence incidence and mortality. Through a thorough search of the literature we aimed to establish and review the current literature related to endometrial cancer risk as well as evaluate the newer methods for prevention and lifestyle modification. Studies have shown increased incidence of disease in women who carry certain genetic mutations like in Lynch syndrome (MSH2, MLH1, MSH6, PMS2), while exposure to unopposed estrogen is believed to account for increased rates in women with infertility, exposure to certain hormones, obesity, diabetes and polycystic ovary syndrome. Factors that appear to be protective include oral contraception use, IUDs, physical activity, smoking, and immune conditions like systemic lupus erythematous. There is significant data supporting several well-known endometrial cancer risk factors including age, race, obesity and unopposed estrogen use. Epidemiologic studies help researchers focus their questions on biologic mechanisms for disease which could be exploited in either treatment (progesterone use for women with grade 1 metastatic endometrial cancer) or prevention (progesterone use in women with endometrial hyperplasia). The role of diet, exercise and agents like metformin in preventing endometrial cancer or survivorship after being diagnosed with disease continues to require further evaluation.