Objective To investigate clinical and histopathological features, dignosis and differential diagnosis of the endometrial microglandular adenocarinoma (MGA). Methods The clinical and pathological features of microglandular adenocarinoma in a patient were observed. Immunohistochemical staining and literature review were also used. Results In the case, the age of patient was 61 years. Clinical manifestation was vaginal irregular bleeding for 1 year. Type-B ultrasound suggested endometrium was irregular thickening. Histologically, it was mainly composed of irregular shape, closely spaced small glands, and glandular cells was mild atypical. Mitosis was rarely observed. The endometrial stromata between gland were rare, but neutrophil were much observed with the formation of neutrophil microabscess in the glandular epithelium. Immunohistochemical study showed neoplastic cells were diffuse and strongly positivity for P16, diffuse positivity for vimentin, focally positive for CEA. ER and PR expression was found in approximately 90% tumor cells. The index of Ki-67 was about 3%. Interstitial cells were positivity for CD10, negativity for CD34. Conclusion The microglandular adenocarcinoma is a rare endometrial adenocarcinoma. It can be differentiated from cervical microglandular hyperplasia(MGH) and cervical mucinous adenocarcinoma by immunohistochemistry and morphological characteristics.