Background Endometrial cancer is a malignant neoplasm of epithelial cells that shows various proportions of glands with papillary and solid architecture with endometrioid cell differentiation resembling the endometrium. Endometrial cancer is the sixth most frequently diagnosed cancer in women with the majority of cases occurring in post-menopause average 61 years old. However, the incidence of endometrial carcinoma increases in pre-menopausal women and women less than 40 years old. Histopathological classification based on tumor morphology and tumor grade has played an important role in the management of endometrial carcinoma, allowing prognostic stratification into different risk categories, and guiding surgical and adjuvant therapy. There are several additional prognostic factors that can improve the prognostic stratification of endometrial carcinoma. Additional prognostic markers by examining immunohistochemical factors, such as L1 transmembrane cell adhesion molecule (L1CAM) expression. L1CAM has emerged as one of the most promising. Method: Descriptive study with 23 paraffin block samples from histerectomy was diagnosed as endometrium carcinoma at Haji Adam Malik and Prof. Dr. Chairuddin P. Lubis Universitas Sumatera Utara Hospital. Assessment was done using staining with hematoxylin and eosin (H&E)  to determine subtype and grading endometrial carcinoma and appraise expression of endometrial tumor cells with L1CAM immunohistochemistry. L1CAM expression was positive if ≥ 10% was stained in the tumor membrane and cytoplasm and negative if < 10% was stained in the tumor membrane and cytoplasm. Results L1CAM immunohistochemistry on the 23 samples,  based on the endometrial carcinoma subtype was most commonly found in the endometrioid carcinoma NOS subtype which expressed positively 46.7%  and based on endometrial carcinoma grading it was high grade endometrial carcinoma in 88.2%. Conclusion Ekspression L1CAM immunohistochemistry was positive in high grade endometrial carcinoma.