Abstract：Objective：To conduct a Pareto chart analysis of the main traditional Chinese medicine syndrome types in hospitalized endometrial cancer patients from Guangzhou city， providing references for clinical syndrome differentiation and treatment decision-making. Methods： A retrospective analysis was performed by collecting basic information and traditional Chinese medicine syndrome differentiation data from 3 391 endometrial cancer patients hospitalized between 2014 and 2024 across four branches of Guangzhou Provincial Hospital of Chinese Medicine in Guangzhou （Dade Road Main Hospital， Ersha Island Hospital， Fangcun Hospital， Higher Education Mega Center Hospital）. A database of 3 391 hospitalized endometrial cancer cases was established，and descriptive analysis，ranksum test， and Pareto chart analysis were applied. Results ： The top five traditional Chinese medicine syndrome types among the 3 391 endometrial cancer patients were spleen deficiency with dampness and stasis，spleen-kidney deficiency， kidney deficiency with blood stasis， spleen-kidney qi deficiency， and qi deficiency with blood stasis， accounting for 80.8% of all traditional Chinese medicine syndrome types. Pareto chart analysis indicated these five syndrome types as the primary syndromes （Category A factors） in hospitalized patients. Subsequently，spleen deficiency with dampness accumulation，qi-blood deficiency，and qi deficiency with phlegm-stasis were identified as secondary traditional Chinese medicine syndromes types （Category B factors， accounting for 10.4%）. The distribution of traditional Chinese medicine syndrome was age-related，with spleen deficiency with dampness and stasis being the most common across all age groups，while spleen-kidney deficiency and kidney deficiency with blood stasis were relatively more frequent in patients aged 45 years and above. Conclusion： Among hospitalized endometrial cancer patients in Guangzhou city，spleen deficiency with dampness and stasis is the most common traditional Chinese medicine syndrome type. The key treatment principles should focus on strengthening the spleen，resolving dampness，and removing stasis. For spleen-kidney deficiency and kidney deficiency with blood stasis， the emphasis should be on strengthening the spleen and tonifying the kidney，and tonifying the spleen and resolving blood stasis.