To explore the clinical efficacy and prognostic factors of minimally invasive laparoscopic surgery and laparotomy in patients with endometrial cancer.Methods Eighty patients with endometrial cancer admitted in our hospital from January 2016 to July 2020 were selected for the study, and randomly divided into minimally invasive group and open group, 40 cases in each group. Minimally invasive laparoscopic surgery and open surgery were performed respectively. The clinical efficacy of the two groups were compared and the influencing factors of patients' prognosis were further analyzed.Results: The operative time, blood loss, indwelling catheter time and hospital stay in the open group significantly increased than those in the minimally invasive group(P<0.05); The postoperative urination function indexes in both groups significantly decreased than those before surgery, the urinary function indexes in the minimally invasive group significantly increased than those in the open group, and the bladder function indexes in the minimally invasive group significantly decreased than those in the open group(P<0.05); The postoperative sexual function score of the two groups significantly decreased than that of the preoperative group, and the postoperative sexual function score of the minimally invasive group significantly increased than that of the open group(P<0.05); The proportion of complications in minimally invasive group and open group was 7.5% and 25.0% respectively(P<0.05); The proportion of patients with endometrial carcinoma aged ≥60 years, pathological stage Ⅰb and open operation with poor prognosis significantly increased(P<0.05; Age ≥60 years, pathological  stage Ⅰb period, laparotomy were independent risk factors for prognosis of patients with endometrial cancer, while laparoscopic minimally invasive surgery was a protective factor for prognosis.Conclusions Endometrial cancer patients with application of minimally invasive laparoscopic surgery can reduce the micturition function, bladder function, sexual function of patients with adverse effect, at the same time, this scheme has shorter operation time, less trauma, lower risk of complications, Elderly patients with endometrial cancer, clinical stage Ⅰb and open operation have a higher risk of poor prognosis,These patients should receive intensive postoperative care, so minimally invasive surgery is a feasible option to reduce the risk of poor prognosis.